Application Form to join the Electronic Constructors Society

Surname       ____________________________________________



First Name    ____________________________________________



Title              ____________________________________________



Address        ____________________________________________



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Post Code      ___________________



Telephone No. __________________________



Email Address ____________________________________________

(If applicable)


Web Site         ____________________________________________

(If applicable)

Membership List

Members' details are stored in the Society's databases 
in accordance with rules of the Data Pro­tection Act. 
A printed membership list is produced about once a year 
and circulated to all mem­bers. The purpose of this list 
is so that members can contact each other for help and 
to discuss matters of interest.

Although the circulation of this list is strictly limited 
to members, a few members, usually for rea­sons of security 
connected to their work, request that not all their details
are included in the Membership List. If this applies to you, 
please give below details of which parts of your personal
details you would like withheld.



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When complete, please return this form, with a year's subscription 
(see "Joining" page for rates) and a stamped self-addressed 
envelope, to:-

		Ron Coates
		2 Boxhill Nurseries,
		Box Hill Road,
		Tadworth,
		Surrey,  KT20  7JF