Form of Application for the Admission of Vice-Patrons, 

 Members, or Associates of the VICTORIA INSTITUTE. 



-I91 



/ 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, state so.) 



Candidate's Title and 

 Name in fidl 



Profession^ University degree^ erv., 

 or other distinction. 



Address _ 



If an Author., the name of the Can- 

 didate's works 7nay be here stated. 



Nominated by 



When filled, this form should be sent — 

 To the Secretary of the Victoria Institute, 



I, Central Buildings, Westminster, S.W. 



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. 



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

 determining any question at a General Meeting. Both Members and 

 Associates receive the Annual Volume of the Transactions, post free. Both 

 are also entitled to attend the Meetings and to bring friends, and to make use 

 of the Library and Reading Boom. 



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

 entitled to become Member 



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

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

 at the Office. Post Ofice Orde7's (on General Post Office) or Cheques should be 

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



All Enquiries or Correspondence should he addressed to the 

 Hon. Seci^tary, E. J. Sewell. 



