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The Support Society for Children of High Intelligence.

Application For Membership.

( Please print this page. )

I wish to apply for family membership at �35.00 pa

Name ..................................................................

Address ..................................................................
..................................................................
..................................................................
Tel. no: day ................... evening .......................
e-mail .....................
Children's names and Dates of Birth:-
..................................................... ....../......./.....
..................................................... ....../......./......
..................................................... ....../......./......

Cheques made payable to: "Children of High Intelligence"
and send to: 45, Ouseley Road, Wraysbury, Berkshire, TW19 5JB