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Membership Application Form PDF Print E-mail
Written by Leng Leng Thang   
Friday, 12 March 2010 07:10
 

APPLICATION FORM FOR MEMBERSHIP OF ICIP

  

Name (include title):

 

Job title:

 

Organisation:

 

Address:

      

Postal code:

 

Country:

 

Telephone (please include the country code):

 

Fax:

 

Email:

  Type of membership (please tick one): 

       Individual member

 

    Organisational member 

    

Please return this form to ICIP, c/o The Beth Johnson Foundation, Parkfield House, 64 Princes Road, Hartshill, Stoke-on-Trent, ST4 7JL, United Kingdom.   Telephone:  +44 1782 844 036  Email:  This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Last Updated on Friday, 12 March 2010 07:10