Credit Card Order Form

Please type information into this form, print off and return to:

Maureen Galbraith
Administrative Secretary
Economic History Society
Dept of Economic & Social History
Unversity of Glasgow
4 University Gardens
Glasgow, G12 8QQ

Email: ehsocsec@arts.gla.ac.uk

Individual membership including subscription to The Economic History Review @ £21.00/US$39.00

Joint membership to The Economic History Society (UK) and the Economic History Association (USA), including a subscription to The Economic History Review and The Journal of Economic History @£44.00/$US$72.00

Student membership including subscription to The Economic History Review @ £4.00
Student membership is open to full and part time students, including post-graduates at higher education institutions in the UK and other E.C. Countries. Please complete the box below.

Proof of student status is required for student membership. Only those registered for a degree and not in full time employment are eligible to claim student status. To enter your membership, please supply the signature of your course supervisor/head of department below and sign below to certify your status.
Please print this form off and then sign - your order cannot be accepted without a real signature.

I certify that I am not in full time employment
(your signature)

Supervisor/Head of Department: I certify that the above student is not in full time employment.

Name:

Position:

Signature:

Institution

CREDIT CARD PAYMENT
Please charge my Mastercard/Visa (please delete as appropriate
Credit Card No:
Amount:	Name on Card:
Signature:	Expiry Date:
First Name:	Last Name:
Address:
Fax:	Telephone:
E-mail:
EHR29WB289/0