Application for FELLOWSHIP 
Professional grade membership of the Geological Society of London

		

To apply for Fellowship you will need a minimum undergraduate level degree in Geoscience or a related subject. see regulations R/FP/1 for eligibility criteria - www.geolsoc.org.uk/regulations
	
 Please tick if you have previously been a Fellow or Candidate Fellow and enter 
Fellow number …………………………………	
PERSONAL DETAILS
	
Title	Last name
	First names (in full)	
Date of birth (dd/mm/yyyy)                     	Gender	Nationality
	
Contact address

Postcode/Zip

Country	Email.
	
	Telephone No.	
MAILING OPTIONS
The Society would like to keep you informed of its activities by email, including those of any Regional and Specialist Groups of which you are a member.  Please tick this box if you do not wish to receive this information.	
  	I wish to receive Geological Society news by email	
  	I wish to receive Geological Society Regional Group news by Email	
	Paper Renewal Invoice 
Membership renewal requests will be sent by email. Please tick this box if you require a paper renewal invoice by post	
The Geological Society will not pass your details to any other organisation. All Fellows names will be added to the online Fellowship directory. 	

ACADEMIC QUALIFICATIONS 
Please supply details of relevant higher education and vocational qualifications 	
University	Course level & title	Date completed	

			

PROPOSERS
Applicants are normally required to find two proposers who are Fellows of the Society. For applicant’s resident overseas and for others who have difficulty in identifying Fellows to act as proposers, Council will act as their proposers	
Proposer 1 	Name & Fellow No.	
Proposer 2 	Name & Fellow No.	
 Please tick this box if you do not have a proposer and require Council to act as your proposer	

DECLARATION BY APPLICANT
	
•	I declare that I am willing to support the aims of the Geological Society of London and wish to apply for admission to Candidate Fellowship/Fellowship of the Society.
•	I declare that the statements made throughout this application are correct.
•	I agree that if elected to Candidate Fellowship/Fellowship, I will observe its Bye-laws and Regulations, including the Code of Conduct (www.geolsoc.org.uk/regulations).
•	I agree that if elected to Candidate Fellowship/Fellowship, I shall endeavour to promote the interests and welfare of the Society.
•	I further agree that I shall pay such dues as required of me on or before the specified dates and in the manner prescribed by Council.
•	I agree to the Society’s terms and conditions for use of electronic services, which can be viewed online at www.geolsoc.org.uk/eterms

Signature_______________________________________________________

Date___________________________

MARKETING

	
To help us improve the quality of service we provide please a take few minutes to answer the questions below;
How did you hear about the society?
 Conference 	
 Event at Burlington House	
 External GSL Event	

 Journal Advertisements	
 Friend/Colleague	
 GSL Fellows	

 University	
 Other	
 please state	

What are your main reasons for applying for Fellowship/Candidate Fellowship?

For office use only	
Election date	Fellow Number	Geo Number	Payment status

MEMBERSHIP SUBSCRIPTIONS 2020
	
	Rate		Amount	
Postgraduate MSc student rate	£31.00			
Postgraduate PhD student rate	£44.00			
Age 27 and under	£95.00*			
Age 28-33	£160.00*			
Age 34-59	£234.00*			
Age 34-59 (overseas)	£184.00*			
Age 60-64	£160.00*			
Age 65-69	£127.00*			
Age 70 plus	£93.00*			
Joint Fellow Rate (per member)**	£159.50*			
*Price includes one-off Admission fee of £20
**For Joint Fellowship please complete two forms	
FREE JOURNAL OPTION	
Choose one option only. Please note your free journal(s) will be provided in electronic format only, unless an annual £16.00 supplement is paid to receive all issues of the free journal in hard copy	Online 	Print 		
Journal of the Geological Society (6 issues per/yr) 
AND Quarterly Journal of Engineering Geology & Hydrogeology (4 issues per/yr)	Free	+£16.00		
		+£16.00		
OR  Petroleum Geoscience (4 issues per/yr)	Free	+£16.00		
OR  Geochemistry: Exploration, Environment, Analysis (4 issues per/yr)	Free	+£16.00		
ADDITIONAL JOURNAL OPTIONS	
	Online 	Print 		
Journal of the Geological Society (6 issues per/yr) 
AND Quarterly Journal of Engineering Geology & Hydrogeology (4 issues per/yr)	£48.00	+£16.00		
		+£16.00		
OR  Petroleum Geoscience (4 issues per/yr)	£48.00	+£16.00		
OR  Geochemistry: Exploration, Environment, Analysis (4 issues per/yr)	£48.00	+£16.00		
TOTAL 		

Credit/Debit Card Charge Authorisation
	
I wish to pay £……………………. by Visa/ MasterCard/American Express
(please delete as necessary)	
Please debit my account number (the long number across the face of the card) :	

Start Date	Expiry Date	Security Code
	
Name on card	Signature
	
Address at which your card is registered
	Date 	

The completed form and payment should be returned to: Fellowship Office, The Geological Society, Burlington House, Piccadilly, London, W1J 0BG, UK.

Please note, all subscriptions are charged for the calendar year January-December 2020, although online services will start from the date your application is processed. Election to Fellowship will take place at the earliest election meeting, of which there are 5 during the course of the year.

To pay by credit card, please supply card details on the enclosed form.  To pay by cheque please make your cheque payable to The Geological Society.