2017 IPI Associate Membership Application (Special Offer)
2017 Special Associate Membership offer: €100 for one year (for new members only)
Thank you for joining IPI. Your membership strengthens our work around the world. We are #StrongerTogether
Your membership application will be reviewed by the IPI Secretariat or the relevant IPI National Committee within a maximum of 10 working days. Please note that in order for your membership application to be valid, you must select a preferred method of payment at the end of this form. Once your application has been approved, we'll contact you to complete payment.
Personal data
Prefix *
Required
Title (academic or other)
Your answer
First Name(s) *
Your answer
Last Name(s) *
Your answer
Position *
Your answer
Organisation *
Your answer
City
Your answer
Country *
Your answer
Phone or Mobile number *
Your answer
E-mail address *
If you have multiple e-mail addresses, please separate with a semicolon (;)
Your answer
May we share your contact details with IPI members?
Sharing your contact data with other members helps strengthen our network. Please choose an option from the list below or specify which information you would like to share by clicking on "other" and entering the information in the box. IPI will never share your information to third parties without your consent.
How would you like to pay your membership dues? *
Required
Privacy policy
IPI takes the privacy of our members and partners seriously. View our Privacy Policy for more information.
Thank you!
We'll contact you within 10 working days. In the meantime, please visit our website http://ipi.media or follow us on Facebook, Twitter or Linkedin. For any questions regarding IPI Membership please contact Christiane Klint, IPI Membership and Global Relations Manager: cklint[at]ipi.media or by phone at : +43 1 512 90 11
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service