SUBSCRIBER APPLICATION FORM

Please print in capital letters

Individual Subscriber

Title _________ Initials __________ Surname ______________________________

Institution/Society Subscriber

Name _______________________________________________________________

Address _____________________________________________________________

____________________________________________________________________

____________________________________________________________________

Postcode _______________ Email address _________________________________

I/We wish to pay an annual subscription to the British Record Society

and enclose a remittance of ____________

(individual subscription £28.00 or US$60.00, institutional subscription £46.00 or US$100.00)

Signature _________________________________ Date ______________________

Please make your cheque payable to "The British Record Society"
and send your completed form and remittance to the Hon Secretary -

Dr Patrick Wallis,
Department of Economic History,
LSE,
Houghton Street
London WC2A 2AE
United Kingdom

email - p.h.wallis@lse.ac.uk

It would be helpful for us to know where you heard of us (please mark with cross):

Internet search ________________________________________

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Personal recommendation _______________________________

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