(* = required field, but please complete all relevant fields)

* Surname:
Select title: Other:
* Forename(s):
Address: Number/Name, Road):
* Your email address:
Partner's name:
Company or companies for which you worked (select):
.. and/or other company:
Approximate start/end dates working for any qualifying company:
Your main work base (select):
.. and/or other base:
Department(s) in which you worked:
Please tell us how you heard about ARTS:

It is ARTS policy to list the names, department and base of new members on the ARTS web site. If you DO NOT wish to be included, please indicate:

Annual Membership fee 1 April to 31 March is £25.00.
PLEASE TICK I confirm that I will immediately effect a Bank Transfer, for the appropriate amount, payable to:

Please include reference (your name) + "membership". Your membership is not effective until the Bank Transfer is complete.

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Data Protection: The details you supply on this form will be stored on a computer and used for administrative purposes only.