AHIS (UK & Ireland) Membership Application

This form has been designed to provide a convenient means of joining AHIS (UK & Ireland) via email. To send, fill in details and click on the button at the end of the form. You can also contact AHIS by mail and send your subscription fee to our postal address.

Please complete all appropriate sections.

Name:
Title:
Organization:
Address:
Tel:
Fax:
E mail:	It is essential that you fill in your email address and fill it in correctly to enable us to reply
Payment:	Please indicate how you intend to pay the 25 pounds sterling subscription fee Please invoice me I will send my payment by mail without an invoice
	PLEASE MAKE ANY CHEQUES/POSTAL ORDERS PAYABLE TO 'AHIS (UK & IRELAND)' AND SEND TO THE HON. SECRETARY as detailed on the How to join page
I/We are willing to be listed in the Directory of Members and the Useful Address list	(Yes) (No)
Please enter any message, comments or questions:
	As a member you will receive occasional mailings regarding AHIS (UK & Ireland) events and services. Please indicate by ticking the box if you do not wish to receive these. The only mailing you will then receive from us will be your copy of the Newsletter
	Please indicate by ticking the box if you do not wish to have your email address added to AHIS-L listserv to participate in communication with other members