MEMBERSHIP CERTIFICATE ORDER FORM
An attractive A4 size membership certificate is available which is suitable for framing. The cost
is £5 inclusive of postage and packing. To order one, please complete the form and return it,
together with your remittance, to:
Membership Office (Certificate), SGM, Marlborough House, Basingstoke Road, Spencers
Wood, Reading RG7 1AG, UK
Fax: 44 (0) 118 988 5656
Enquiries: Email: members@sgm.ac.uk
Please note that a certificate can only be supplied if your subscription has been paid for
the current year.
PLEASE TYPE OR COMPLETE IN BLOCK CAPITALS
Full Name (as you wish it to appear on the certificate)
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Membership Number ...................................................................................................................
Address to which certificate should be sent
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Contact details (in case of enquiry)
Tel........................................................... Email..........................................................................
PAYMENT
Payment will only be accepted in £ sterling. Members sending payment from abroad should ensure that
they pay all charges associated with draft so that the full sterling amount due is paid to the Society. A
certificate will not be supplied unless this condition has been met.
I enclose a cheque (made payable to Society for General Microbiology) for £5.
I wish to pay by credit card (Please note that all credit card transactions will be in £ sterling and
no cards other than those indicated can be accepted).
My Access/Eurocard/Mastercard/Visa number is (circle appropriate card)
Card Security Code Expiry Date
I authorize you to debit my Credit Card Account to the value of £5.
Signature ................................................................. Date ........................................................................
Cardholder’s address (to which your credit card is sent)
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