NORTHAMPTONSHIRE INDUSTRIAL
ARCHAEOLOGY GROUP
NIAG membership for the year 2008-
Single Member £7.50 Joint Membership £10.00
I enclose £……………… as my/our subscription to NIAG for the year ending
31st August 2009.
Name …………………………………………………………………………
Address ……………………………………………………………………….
……………………………………………………………………….
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e-
Signature ……………………………………………………………………...
Your details will not be given out to third parties without your express permission.
Area of expertise or special interest.This is purely voluntary, you may leave this section blank if you wish
…………………………………………………………………………………….
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Please return this application together with your remittance to
Jan R C Fajkus
101, Holly Road, 01604 622158
Northampton,
NN1 4QN jan@fajkus.com
NIAG Membership application form. You may print out this form and send it with your subscription fee to
Jan Fajkus
101 Holly Road,
Northampton ,
NN1 4QN