I wish to become a member of The D.H. Lawrence Society:

Name (Mr/Mrs/Ms) ...................................................................

Address(please print).................................................................................................

................................................................................................................

Postal Code........................................................... Tel No:...................................

I wish to apply for membership of the societyand agree to abide by the rules and constitution drawn up by the Council.

I enclose membership fee (Please tick where applicable)

Ordinary membership	£14.00	..........
Concessions	£13.00	..........
European membership	£16.00	..........
Other overseas members	£19.00	..........

Cheques and postal orders (sterling only, please)
should be made payable to The D H Lawrence Society
and forwarded with this form to the Treasurer.
Leslie Parkes
1, Gorse Close, Newthorpe, Notts, NG16 2BZ