Form of Application for the Admission of Vice- Patrons, 

 Members, or Associates of the VICTORIA INSTITUTE. 



_I92 



/ hereby desire to be enrolled a * of the Victoria 



Institute, or Philosophical Society of Great Britain. 



* Here insert ivhether as Vice-Patron, Member, or Associate. (If for life, state so.) 



Candidate's Title a?id 

 Name in full 



Profession^ University degree^ 6^r., 

 or other distinction. 



Address 



If an Author, the name of the Can- 

 didate's works may 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 Room. 



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

 entitled to become Members!] 



Subscriptions are payable to tlie 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 Office Ordei^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. Secretary^ W. Hoste. 



