Membership Proposal

Name:

Position:

Academic qualifications:

Address:

Phone:

Fax:

E-mail:

Research interests (5 keywords):

Membership of other scientific societies:

Proposers (names and signatures of current Anatomical Society members):

(1):

(2):

I wish to apply for Ordinary Membership of the Anatomical Society of Great Britain and Ireland.

Applicant's signature:

A hard copy print-out of this form should be completed and sent to:

Professor John Morris, Assistant Secretary (Membership),
The Anatomical Society of Great Britain and Ireland,
Department of Human Anatomy and Genetics,
University of Oxford,
South Parks Road,
Oxford OX1 3QX,
U.K.

Persons registered for a higher degree who wish to apply for Membership at the reduced subscription rate should also include a letter from their Supervisor or Head of Department confirming their status.