Global Affiliate membership application form

Please complete the form below to apply for Global Affiliate membership.

Note: All membership applications will be processed and a membership number emailed to you by 5pm on the Monday following receipt of your application. You will not be able to access the member only sections of the website until you receive your membership number.

Personal details

Promotional code (if applicable)

Title * (Mr, Miss, Mrs, Ms etc)

Forename(s) *

Surname *

Job title

Company

Company description Please give a brief description of your organisation's activities.

Address *

Post code

Country *

Is this your home or work address? Home Work

Home telephone * inc international code

Work telephone * inc international code

Mobile telephone * inc international code

Fax

Email address *

Company website address http://

Date of birth * Note: dd/mm/yyyy

Payment details

Price: £80

Please note, all cards will be debited in pounds sterling, at the prevailing exchange rate set by your card provider or bank.

You will be directed to PayPal to make your purchase. You do not need to be a PayPal member to make a credit or debit card payment.

Application statement (terms and conditions)

I wish to apply for Global Affiliate membership of the Chartered Institute of Public Relations (UK). I understand that this is a non-professional online grade of membership, which excludes access to certain member benefits as outlined on the CIPR website (including all CIPR mailings). I understand that the membership fee outlined above is for one year's membership only and may vary in the future.

Membership is by annual subscription and cannot be refunded or transferred once your membership has been activated.

I also understand and agree to abide by the conditions set down in the CIPR Code of Conduct. I am aware and agree that failure to abide by these conditions, including any misuse of my membership - including usage of the CIPR membership database for any purpose other than personal reference - may result in the termination of my membership and forfeiture of my membership fees.

Please tick here to indicate you agree to the above *

Staying in touch with the CIPR

Your contact details will be published in our online member-only directory and we will send you regular emails about CIPR activities, initiatives and events.

Please indicate here if you do not wish to receive the following CIPR communications: CIPR HQ email newsletters

Please press submit to make your application.

For further information or queries, please contact Membership@cipr.co.uk

CIPR

MEMBERSHIP & NETWORKING