UAHS Membership form

Yes, I would like to join the UAHS.

Name Title

Address

Tel (home) Tel (work)
E-mail

Areas of particular concern (if any):

Current membership rates are: Annual membership £20; Joint annual membership (two members at same address) £30; Corporate annual membership £100; Students (up to 25 years old) annual membership £10.
Members paying by direct debit are entitled to a £1 discount in their subscription rate. Forms are available on request.

I enclose a cheque for £

Please print out this membership form and send it with your cheque to the Secretary at 66 Donegall Pass, Belfast BT7 1BU, Northern Ireland. Thank you.

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