THE BURGON SOCIETY
Founded to promote the study of Academical Dress

Membership Application Form

Membership of the Burgon Society costs £30.00 per year for individual members (£35.00 outside the UK), and £50.00 per year for corporate members. As a Member, you will be entitled to attend meetings and receive copies of the Society's mailings. Upon successful submission of a research paper, you will be made a Fellow of the Burgon Society, which will additionally entitle you to vote at meetings, use the post-nominal letters FBS and wear the Society's hood.

To join the Burgon Society, simply complete the following application form and send it to: Nicholas Jackson, 102 Canley Road, Coventry, CV5 6AR. You can either pay by enclosing a cheque for the appropriate sum in sterling (made payable to The Burgon Society) or by bank transfer to account no. 71376233, sort code 40-01-24 (quoting your name in the reference field).

If you live outside the UK, you can either: pay by banker's draft in UK pounds drawn on a corresponding UK bank; arrange for your bank to make a payment directly to our bank quoting IBAN GB37 MIDL 4001 2471 3762 33 and BIC MIDL GB2105N; or if you have a Paypal account, you can transfer your payment using our PayPal email address, iaj123@aol.com.

Title (Mr/Mrs/Dr etc)
Forename(s)
Surname
Degrees held (& Institution)
Diplomas/Fellowships
Profession/Occupation
Address
Town/City
County/State
Postcode/Zipcode
Country
E-Mail Address
Telephone No Home Work Mobile
How did you first hear about us ?
Particular area(s) of interest History Practice Design Other
(If other, please specify)

Please register me as a member of the Burgon Society.

I am paying my membership fees by cheque / banker's draft / bank transfer / PayPal (select as appropriate).

If you pay tax in the UK, the Burgon Society is able to reclaim the tax paid on your membership subscription if you enclose a gift aid declaration with your membership form.

A condition of membership is your agreement to the Society holding your details on computer under the headings shown on this form. The information is used solely in the efficient running of the Society by its officers and is not divulged to third parties.

The Burgon Society is a registered charity in England and Wales (no. 1137522).