Field Naturalists Club of Victoria 



APPLICATION FORM 



To be used by new members or subscribers. 



(Cross out parts which arc not applicable) 



I wish to subscribe to the Victorian Naturalist for 1971. Please post 

 it monthly to the address below. 



Ordinary 



I wish to apply for Country membership of the Field Naturalists C luh 

 Junior 



of Victoria. 



My full name and address is: 

 Mr. 



Mrs - - 



Miss 



I enclose the sum of S 

 Date /1971. 



in payment of the year's fee. 



