IFEG APPLICATION FORM

Please complete the form and fax/e-mail/post to:
Emily Heath, Energy Institute, 61 New Cavendish Street, London W1G 7AR.
f: +44 (0)20 7255 1472 e: eheath@energyinst.org

I wish to pay annual subscription for membership of IFEG.

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Title	Mr Mrs Miss Ms Dr
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Organisation Address
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Areas of interest (e.g. oil, gas, electricity, nuclear, etc) (You may enter a brief description of not more than 30 words to describe your, or your organisation's activities):
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The above information will be used in the IFEG members directory unless you indicate otherwise. We reserve the right to edit entries.

The subscription fee of £25 (50% discount for unwaged members) may be paid by (please check appropriate box):

Please note if you are submitting this form electronically that this is NOT a secure server. You may prefer to telephone with your credit card details on +44 (0)20 7467 7115.