This form may be filled in on the screen. It must then be printed off and returned to us with an example of your organisation's headed note paper and your payment.

I wish to apply for membership of the IAPSC and enclose a cheque to the value of £250.28 (£213 + VAT) subscription fee for the year 2008 - 09. I attach enclose an example of my headed note paper.  Please make your cheque payable to 'AEA Technology Environment (IAPSC)'.

Note:
1.	The above annual subscription entitles each member body to send two representatives to each of the two conferences.
2.	All correspondence, and the annual subscription invoice will be sent to the address of the representative given below.

Name:
Organisation:
Address:
Post Code:
Telephone:		Fax:
E-mail:

Signature:

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Date:

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