Individual Membership Form

INDIVIDUAL MEMBERSHIP FORM

Individual Membership
From all African countries: R640
From all other countries: US$202

PERSONAL INFORMATION
Prefix
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Telephone
Mobile
ORGANISATION
Organisation Name
Organisation Type
Organisation Website
Job Title
Division / Department
Your Primary Function
DEMOGRAPHICS
Gender
Nationality
Country
Highest level of Education
Main area of Interest
Secondary area of Interest
Any other areas of Interest
Years worked in Higher Education
Extract from the IEASA Constitution (January 2021)

Membership
7.3.2 Responsibilities
7.3.2.1 Members are expected to actively promote and support the furtherance of the Association’s purpose and objectives, within the Association, their member institutions as well as national and international networks.
7.3.2.2 Members are expected to conduct themselves in a professional and ethical manner.
I agree
By ticking the box you agree to the above
Consent
I accept the following:
Electronic Signature Agreement:
By selecting the "I accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I accept" you consent to be legally bound by this Agreement's terms and conditions.
Email
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Individual Membership