APPLICATION FORM.

To the Hon. Secretary, Entertainments Committee.

Please send me one Ticket for my own use (and one for a guest[P]), Seven Shillings and Sixpence (10 frcs.) each, for the Inaugural Banquet of the First International Eugenics Congress to be held at the Hotel Cecil, Strand, at 7 p.m., July 24th. I enclose £ s. d.
Name _____________________________________________________________
(Member of the Congress).
Address __________________________________________________________
__________________________________________________________

N.B.—This form should be sent immediately to the Hon. Secretary,
Entertainments Committee, 30, York Terrace, Harley Street.

[P] Strike out if not wanted.