Form of Application for the Admission of Vice-Patrons, 

 Members, or Associates of the VICTORIA LxSTlTUTE. 



191 



/ 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 

 Na?ne in full 



Profession, University degree, c^^r., 

 or other distinctio'n. 



Address 



If an Author, the name of the Can- f 



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 Heading Eoom, 



[It is to be understood, that only sucli as are pn-fessedly Christians are 

 entitled to become Members^ 



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

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

 at the Office. Post Office Orders (on General Post Office) or Cheques should he 

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



All Enquiries or Correspcmdence should be addressed to the 

 Bon. Sic'i^tary, E. J. Sewell. 



