ASEAN Learning Network Individual Membership Application Form 2020/2021 (FOR NEW MEMBERS ONLY)
Welcome to the ASEAN Learning Network.

Kindly complete this form to apply for individual membership to the ASEAN Learning Network.
Please note that individual membership is valid for one fiscal year only, beginning July 1 through June 30 of each current year. Please submit your membership application within the fiscal year and send the payment of the membership fee once notified of acceptance.

*Please note that submission of the accomplished membership application form does not warrant membership acceptance. You will be notified of acceptance . A membership invoice will be emailed to you once your application is endorsed by the ALN Management Team.

For more information about the ASEAN Learning Network, please visit: www.aseanlearningnetwork.org

You may send an email to [admin@aseanlearningnetwork.org] if you do not hear from us within 14 working days after submission. Thank you.
Email address *
Title (Dato'/ Datuk/ Prof/ Assoc Prof/ Dr/Mr/Ms) *
First Name *
Last Name/ Family Name *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Nationality *
Identity Card/Passport No. *
Mobile Phone No. (please include country code)
Correspondence Address *
Organization *
Position *
Address of Organization *
Office Phone (if any)
Office Email (if any)
Personal Email *
Highest Academic Qualification *
Major subject(s)/Course Program at a university (undergraduate and/or post-graduate student) *
Subjects being taught/handled (for faculty or former faculty member of university) *
I hereby declare that this is my first application for ALN individual membership: *
If your registration is based on existing ALN member's recommendation/ invitation, please kindly indicate his/ her name.
Compliance *
Required
Payment of membership fee (CHF20/year) can be directly transferred to:
Method 1: Telegraphic Transfer
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

Method 2: Country Collection
For those who do not wish to transfer the fee online, payment of the individual membership fee can be done through the following:
Deputy Executive Director - Assoc Prof Dr Wee Yu Ghee (weeyughee@gmail.com) - Malaysia
Executive Director - Prof Dr Tita Evasco-Branzuela (vp.lia@sanbeda.edu.ph) - Philippines
? ________________ Indonesia

They will collect the fees and immediately transfer all at once to the Asean Learning Network before the deadline. This will help in saving additional transaction costs imposed by the local bank(s).
Please email the payment slip to admin@aseanlearningnetwork.org
*Please note that membership registration does not amount to membership acceptance. You will be notified of membership acceptance within five working days 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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