APPLICATION FOR MAILING LIST REGISTRATION
To:
Maria Frabboni
BLACA Treasurer
22A Cologne Road
London
SW11 2AJ
I am a registered ………………………………………….. 1 student reading for the following
course(s):2
……………………………………………………………………………………………………………
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I am applying for BLACA Mailing List Registration, for the period November 20__-November 20__.
I enclose £20 for the registration fee.
I understand that mailing list registration does not constitute membership of BLACA and only entitles
me to attend the BLACA bi-monthly lectures for the abovementioned period. No refund of my
registration fee is due to me if I do not attend the lectures or any of them.
[PLEASE PRINT IN BLOCK LETTERS]:
FULL NAME:
………………………………………………………………………….
COLLEGE:
………………………………………………………………………….
ADDRESS:
………………………………………………………………………….
………………………………………………………………………….
E-MAIL:
………………………………………………………………………….
DATE:
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RECEIPT
Received £20 mailing registration fee:
………………………………………………
for and on behalf of BLACA
………………………………………………
Date
Chairman
Gillian Davies
Vice Chairman
Professor Alison Firth
Vice Chairman
Tom Rivers
Treasurer
Maria Frabboni
Secretary
Simon Clark
1
State name of educational establishment
2
State name of course(s)
Committee Members
Stephen Edwards
Brigitte Linder
Gaetano Dimita
erum/11680953.1
Uma Suthersanen