463 



FORM B. 



SiR> 18 . 



1 have the pleasure to inform you, with reference to 

 your application dated the , that you have 



duly been elected a of the Victoria Institute, or 



Philosophical Society op Great Britain. 



I have the honour to be, 

 Sir, 



Your faithful Servant, 

 To Hon. Sec. 



FORM C. 



{Bankers) ' Messrs . 



* Please pay Messrs. Ransom, Bouverie, & Co. my 

 Annual Contribution of Two Guineas to the VICTORIA 

 INSTITUTE, due on the 1st of January, 187 , and the 

 same amount on that day in every succeeding yearj until 

 further notice. 



I am. 



Your obedient Servant, 



^ 187 . 



If this Form be used, please add your Signature, Banker's Name, and the 

 Date, and return it to the Office, 8, Adelphi Terrace. Receipt-stanap required. 



* The above is the form for Members. The form for Associates is the same, 

 except that the Subscription stands as "One Guinea." 



