Form of Application for the Admission of Vice-Patrons, 

 Members, or Associates of the Victoria Institute. 



192 



/ hereby desire to be enrolled a " of the 



Victoria Institute, or Philosophical Society of Great Britain. 



* Here insert whether as Vice-Patron, Member, or Associate. (If for life, stat^so.) 



Candidate's Title and ~ =~— ^ 



Name in full [ 



Profession, University, degree, &c., j 

 or other distinction. | 



A ddress 



// an Author, the name of the Can- | 

 didate's works may be here stated. J 



Nominated by 



When filled, this form should be sent — 



To the Secretary of the Victoria Institute, 



1, Central Buildings, Westminster, S.W. 1. 



MEMBERS AND ASSOCIATES. 



The Annual Subscription is Two Guineas for Members ; One Guinea for 

 Associates. Or, in lieu of Annual Subscription, the payment of Twenty Guineas will 

 constitute a Life Member, or of Ten Guineas a Life Associate. 



Both Members and Associates receive the Annual Volume of the Transactions, 

 post free, but Members alone are eligible to vote in the election of the Council, or in 

 determining any question at a General Meeting. 



[It is to be understood, that only such as are professedly Christians are entitled to 

 become Memhers.l 



Subscriptions are payable to the credit of the " Victoria Institute" at 

 *' Barclay's Bank," 1, Pall Mall East, S.W. 1., or may be remitted to the Secretary, at 

 the Office. Pott Office Orders (on General Post Office) or Cheaues should be made 

 payable to " Victoria Institute or order " and crossed " Barclay & Co." 



All Enquiries or Correspondence should he addretsed to the 

 Hon. Secretary, W. Hoste. 



