ITPA Membership RENEWAL Application - EXISTING members only.
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:
 

e-mail:

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

I am a Student/Trainee* and wish to renew as a 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 £380, being my annual subscription. Please send me details of your forthcoming meeting in Amsterdam.
  • Library membership - I agree to pay £120, being my annual subscription.
  • Student membership - I agree to pay £110, being my annual subscription. I enclose/fax* evidence of my continuing 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 only)

VisaMasterCardAMEXDinerscard

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)
Signature: Date:

 
*Delete as appropriate

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 itpaweb/jul2010