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 £530, being my enrolment fee (£130) and my subscription (£400) to 31st December 2012.
    Please send me details of your forthcoming meetings in Monte-Carlo, Luxembourg & Madrid.
  • Library membership - I agree to pay £160, being my enrolment fee (£40) and my subscription (£120) to 31st December 2012.
  • Student membership - I agree to pay £110, being my subscription to 31s December 2012. 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.

Please charge my credit card (credit card charges are made in £ sterling)
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

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 latest ITPA Diary
The password and user name to access the Members' Pages on the website
A Certificate of Membership
A booking form for your meetings in:
Luxembourg 16-18 October 2011
Madrid 18-20 March 2012
Cannes 10-12 June 2012
Signature: Date:

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 itpaweb/01jul2011