Xii 
FORM B. 
Sir, 19 
I have the pleasure to inform you, with reference to 
your application dated the , that you have 
duly been elected a of the Victoria INsTITUTE, OR 
PHILOSOPHICAL Sociery OF GREAT BRITAIN. 
I have the honour to be, Sir, 
Your faithful Servant, 
To Hon. Sec. 
FORM C. 
(Bankers) Messrs. 
* Please pay Messrs. Ransom, Bouveriz, & Co. my Annual 
Contribution cf Two Guineas to the VICTORIA INSTITUTE, 
due on the Ist of January, 19 , and the same amount on that 
day in every succeeding year, until further notice. 
I am, 
Your obedient Servant, 
1Ot 
If this Form be used, please add your Signature, Banker’s Name, and the 
Date, and return it to the Office, Adelphi Terrace. Receipt-stamp required. 
* The above is the form for Members. The form for Associates is the same 
except that the Subscription stands as “ONE GUINEA.” 
