

Please sign this form of receipt and return promptly 

 to the Royal Society of New South Wales, 5 Elizabeth-street, 

 Sydney, Australia. 



|!Utctbtu~ from the Royal Society of New South 



Wales 



JOURNAL AND PROCEEDINGS OF THE ROYAL 

 SOCIETY OF N. S. WALES. 



Vol. LY., 1921 



Name of Institution, eic. 



Address in full.. 



Date 



Signature or Stamp 



