ASEAN Learning Network Institutional Membership Registration Form 2019/2020
Kindly complete this form to become an institutional member in ASEAN Learning Network. Please note that institutional memberships are for the fiscal year beginning July 1 through June 30. Please submit your membership application and payment (*upon membership acceptance) within the fiscal year. Deadline of registration: June 30, 2019.

*Please note that membership registration does not amount to membership acceptance. You will be notified of membership acceptance after registration submission. A membership invoice will be emailed to you once your registration is endorsed by ALN Management Team.

You may drop us an email [admin@aseanlearningnetwork.org] if you do not hear from us within 14 working days after registration submission. Thank You.
Email address *
Name of Establishment *
Your answer
Date of Inception *
Your answer
Address *
Your answer
Contact No. *
Your answer
Nature of Business
Your answer
Total number of students (undergraduate and postgraduate) *
Your answer
Total number of academic staff
Your answer
Total number of support/ administrative staff *
Your answer
Name and Designation of the Head of the Establishment *
Your answer
Email of the Head of the Establishment *
Your answer
First Official Representative whom correspondence is to be made (Name, Position and Email Address) *
Your answer
Second Official Representative whom correspondence is to be made (Name, Position and Email Address) *
Your answer
Type of Registration *
Declaration *
Required
Payment of annual institutional membership fees (CHF360/year) can be directly transferred to
Bank Name: UBS Switzerland AG
Bank Address: Postfach 1917, 4601 Olten, Switzerland
Beneficiary Name: Asean Learning Network
Beneficiary Address: Peter-und-Paulstrasse 46, 9010 St Gallen, Switzerland
IBAN: CH43 0026 1261 1108 4040 D
Account number: 261-110840.40D
SWIFT/BIC: UBSWCHZH80A
Please email the payment slip to admin@aseanlearningnetwork.org (after you are given a membership invoice and payment has been made thereafter). Any further enquiries can be forwarded admin@aseanlearningnetwork.org
*Please note that membership registration does not amount to membership acceptance. You will be notified of membership acceptance after registration submission. A membership invoice will be emailed to you once your registration is endorsed by ALN Management Team.

You may drop us an email [admin@aseanlearningnetwork.org] if you do not hear from us within 14 working days after registration submission. Thank You for your kind support.
A copy of your responses will be emailed to the address you provided.
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