WEB Site -Application for Membership. (Please print this form and forward by mail services.)

UK membership 4 Journals £15.00, Continental Europe £18.00, USA $32, Rest of World £22.00
(Journals are sent outside UK via airmail.) ***************************************************************
Payment by cheque: Made out to RIG or Remote Imaging Group

Amount: _________

(Only UK cheques accepted - no foreign currency please)
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Payment by credit card: "VISA/ MasterCard/ Switch/ Switch Solo" accepted
amount: _________ (In Pounds Sterling) (Amex and Diners Card facilities not currently available.)

Card Number

|__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__|__|__| If using SWITCH please add Issue No |__||__|

Expiry date |__|__| |__|__|. . Tick Box for automatic Credit Card renewal every year |__|

Security Number |__|__|__|

Signature ________________________ (ALL cards authorised before action taken)
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Name___________________________ e-mail _____________________

Address_____________________________________________________

_____________________________________________________________

Country __________________ Post Code ________________________

Telephone_________________ Call Sign _______________________

Are you willing to have your details made known to other members in your area? YES / NO.
DECLARATION. (To comply with UK law) I do NOT object to the Remote Imaging Group holding my membership details on a computer.

Signed ________________________ date __________

Please -

Mail To: RIG-SUB, RIG, PO Box 2001, Dartmouth, Devon, TQ6 9QN United Kingdom

If paying by credit card then Fax To: 01803 839498