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ITPA Membership Application - NEW members only. Current members renewing, click here.
Please complete all fields & select appropriate options, then print, delete as appropriate, sign, and post/ fax this form to:

The Registrar, ITPA, PO Box 1508, St Helier, Jersey, JE4 2YE Fax: +44 1534 855488

Name:

Company:

Address:

Tel:

Fax:

I heard about the ITPA from:

e-mail:

I wish to join as a Full Member I wish to join as a Library Member

I am a Student/Trainee* and wish to join as an Student Member
 A bona fide student/trainee is a person who is not in employment (except under a student training contract). Students will be required to supply relevant evidence when submitting the application form.
  • Full membership - I agree to pay £510, being my enrolment fee (£130) and my subscription (£380) to 31st December 2011. Please send me details of your forthcoming meeting in Amsterdam.
  • Library membership - I agree to pay £160, being my enrolment fee (£40) and my subscription (£120) to 31st December 2011.
  • Student membership - I agree to pay £110, being my subscription to 31st December 2011. I enclose/fax* evidence of my Student/Trainee* status.
Membership is subject to the Articles of Association and to the Conditions of Membership published on the Association's website.

A sterling cheque drawn on a UK bank in favour of the ITPA is attached/is in the mail
 I wish to pay by cheque in (state currency). Please tell me the corresponding amount in this currency
Please charge my credit card (credit card charges are made in £ sterling)

Visa MasterCard AMEX Dinerscard

Card Number - please include all 16 digits (15 for AMEX and Diners) :

Expiry date:

Amount : £

Name on card:

Security code : last 3 digits on signature strip (except AMEX, which has 4 digits above card number)
Please send me the following as indicated (for which there is no charge):
A hard copy of the Directory of Members
The ITPA Diary for 2011
The password and user name to access the Members' Pages on the website
An email address in the form NAME@itpa.org
A Certificate of Membership
A booking form for your meetings in:
    Amsterdam 7-9 November 2010
    Montreux 13-15 March 2011
    Monte-Carlo 5-7 June 2011
Signature: Date:

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 itpaweb/01jul2010