THE BRITISH SOUND RECORDING ASSOCIATION MEMBERSHIP APPLICATION FORM Please print this form using a fixed width font (e.g. Courier). Please send the completed form to the BSRA Membership Secretary David Holland, 23 Millway Avenue, Roydon, DISS, Norfolk. IP22 4QL Name and Style: _____________________________________________________________ Address: ____________________________________________________________________ _____________________________________________________________________________ Postcode: __________________________ Telephone: _____________________________ E-mail address: _____________________________________________________________ BSRA Membership and Insignia £ Quantity Total Individual Membership 23.00 _______ _______ Overseas Membership 28.50 _______ _______ Family Membership 28.50 _______ _______ Club Membership 29.00 _______ _______ Associate Membership 18.00 _______ _______ Trade Associateship 50.00 _______ _______ Trade Associate Additional Staff Member 18.00 _______ _______ MCPS Recording Licence (inc. 50p administration fee) 3.00 _______ _______ BSRA Polo Shirt state size: M / L / XL 12.50 _______ _______ BSRA Badge - butterfly fitting 1.50 _______ _______ BSRA Badge - flat for equipment 1.50 _______ _______ BSRA Badge - stick pin with cap 1.60 _______ _______ BSRA Tie-Tac 1.60 _______ _______ BSRA Cuff Links (pair) 3.50 _______ _______ FICS Tie (Navy) 5.00 _______ _______ Postage: Shirt £1.50, tie £1.00, badge(s) 50p. Add only the highest charge that applies. _______ Grand Total (payable to "B.S.R.A.") _______ Name of Club (for Associate Membership): ____________________________________ I apply for membership of the BSRA and do not object to my membership details being held on a computer file. Signed: __________________________________ Date: ____________________________ How did you hear about the Association? _____________________________________