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Please print, complete and mail in. If sent from outside the UK, please pay in paper money in your own currency to the equivalent value, as the cost of cashing cheques internationally is greater than the membership fee. Return To New Atlantis Internet Club description.
Membership application form New Atlantis Internet Club I wish to become a member of the NAIC, and agree to abide by its rules. I may leave at any time. I understand that membership fees are not refundable.
Title Mr/Mrs/Miss/Ms First Name Surname Address
Postcode/Zipcode Country if outside the UK Telephone number Fax number Date of Birth Age Please tick the items below as appropriate Do you already have a o Computer o Modem o Internet account o Email account
What is your level of experience o Absolute beginner o Computer literate but new to the Internet o Some experience of the Internet o Quite a lot of experience.
I wish to become o A member £10 pa, £10 is enclosed. o A business member £25 pa, £25 is enclosed. If UK:- Cheques or postal orders made payable to Maximum Coverage Ltd please. Outside UK:- Please pay with paper currency, as cheque clearing costs are greater than these amounts.
New Atlantis Internet Club, PO Box 403, Gloucester GL2 5YG, UK Tel 01452 413702 (+44 1452 413702) Fax: 01452 524863 (+44 1452 524863) Email naic@new-atlantis.org
New Atlantis is a non profit company, a company limited by guarantee, registered in England and Wales no 3207338.
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