TTHA: Membership Application Form

TTHA Membership Application Form

TTHA regrets that is can no longer offer a dual membership service with the Hardy Society

Membership offers the following to all:

(Please check the option selected by you.)

	A. INDIVIDUALS APPLYING FOR TTHA Membership $40.00/Ł30.00
	B. COUPLES APPLYING FOR Membership: $55.00/Ł45.00
	C. STUDENTS Applying for membership $30.50 /Ł25.50.00 Institutional Membership: $65.00/Ł50.00 LIFE: $450. 00 / Ł350.00 Please state affiliation:

	D. INDIVIDUALS APPLYING FOR MEMBERSHIP OF TTHA $40.00/Ł30.00.
	E. COUPLES APPLYING FOR MEMBERSHIP OF TTHA $55.00/Ł45.00.
	F. STUDENT MEMBERSHIP OF TTHA $ $30.50/Ł25.50. Institutional Membership $65.00/Ł50.00 LIFE: $450. 00 / Ł350.00 Please state affiliation:

Method of Payment:
Please send your cheque payable to: Rosemarie Morgan, 124, Bishop St, New Haven, CT 06511, USA (e-mail: rm82@pantheon.yale.edu).

Payment can also be made using UK sterling cheques and international money orders.

NAME:
ADDRESS:
POSTCODE:
COUNTRY:
E-MAIL:
PHONE:
FAX:
OCCUPATION:
EDUCATION:
INTERESTS:
IDEAS FOR SOCIETY ACTIVITIES: