Membership application form

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Membership Category
Please select the category that best describes you:*
The membership fee only becomes payable if/when your application is successful. You will be notified if/when payment is due.
Applicant Details
First Name*
Last Name*
Title*
Institution*
Job*
Area*
Address*
Address Line 1* Address Line 2 City / Town* County* Eircode
Telephone*
Email*

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Name:	Awarding Body:	Year Obtained:
			Add Degree Remove Degree

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References
Proposer* (Proposers are required for Professional/Allied Professional Membership only)
Name:*
Email:*
Seconder*
Name:*
Email:*
Member Newsgroup
Members of the IAPM are granted access to a member-only newsgroup where they can share news and information with professional peers. Please tick the box below if you would like to subscribe.
Member Newsgroup
- Members of the IAPM are granted access to a member-only newsgroup where they can share news and information with professional peers. Please tick the box below if you would like to subscribe.
Data Consent
Any personal data you provide in this form will be treated in the strictest of confidence and in full compliance with GDPR legislation. When you submit this form, the identifying information you have specified (name, email, telephone etc.) will be held by us for the purpose of communicating with you about your IAPM membership. If you are happy for your data to be stored and used in this way, please tick the box below.
Data Consent*
- I consent to the IAPM storing and using my personal data for the purpose of communicating with me about my IAPM membership.

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Membership Category