AIA : Membership Application Form

The AIA's membership is administered by Taylor & Francis on our behalf. An on-line application is available but this form can be used for postal applications.
Please complete this form then print it out and send it with payment to:
Taylor & Francis Customer Services, Informa UK Ltd, Sheepen Place, Colchester, Essex CO3 3LP, UK

If you are a UK tax payer we would appreciate it if you are able to complete and enclose a Gift Aid form also.


Please enrol me / us / my organisation as a member of the Association for Industrial Archaeology in the category shown below:


I / We acknowledge that in the event of the winding up of the AIA I / we will be liable for an amount not exceeding £1.00.

Title First name Surname
Organisation (if any)
Address
Town / City Telephone
State (not UK) Email
Post / Zip Code
Country Date

Signature

Please send a direct debit authority (UK bank accounts only)

I enclose payment by sterling cheque for £...................... payable to Taylor & Francis
or
Please debit my Visa/MasterCard/AMEX/Switch card

Card Number Card expiry

Issue No. (Switch only)

The Association for Industrial Archaeology is registered in England under the Companies Act 1948 (No 1326854) and the Charities Act 1960 (No 277511)
Registered Office: c/o IGMT, Coach Road, Coalbrookdale, Telford TF8 7DQ

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