Application for Associate Institutional Member
Name
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Address
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Tel. No
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Fax No.
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Website Address
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REPRESENTATIVE
Name
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Position
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Tel No.
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Fax No.
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Email Address
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DECLARATION (Please complete relevant declaration)
Name of Institution / Association - Applicant
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I declare that this organization/institution is an audiovisual archive within the definition set out in Article I of the Constitution, and that it will subscribe to the Constitution and objectives, abide by the rules of the Association and will work in cooperation with existing members in (Please indicate name of country)
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Signature of Representative:
For e-signature, kindly upload
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DESCRIPTION OF ARCHIVE / INSTITUTION / ASSOCIATION *
Following is a description of my archive/institution/association and its objectives. For archives, please include collection size, budget, staffing, and policies.
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