To the Honorary Officers of the Victoria Institute, 
8, Adel phi Terrace, Strand, London, W.C. 
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FOHM A. 
Form of Application for the Admission of Vice-Patrons , Members, or Associates of 
the Victoria Institute. 
[Pate]- — - — 187 . 
I hereby desire to be enrolled a * — = — —A — ; * — <_, ; A- /— i : — = — . — '—of the Victoria 
