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,
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                                   26.00 _______ _______
Overseas Membership                                     32.00 _______ _______
Family Membership                                       32.00 _______ _______
Club Membership                                         32.00 _______ _______
Trade Associateship                                     50.00 _______ _______
MCPS Recording Licence (inc. 50p administration fee)     3.00 _______ _______
BSRA Polo Shirt XL or M only (inc. postage)             15.00 _______ _______
BSRA Badge - butterfly fitting                           2.00 _______ _______
FICS  Tie (Navy)                                         2.00 _______ _______


Grand Total (payable to "B.S.R.A.")                                   _______

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? _____________________________________

Recording interests: