Student Membership Form

STUDENT MEMBERSHIP FORM

Student Membership
From all African countries: R180

PERSONAL INFORMATION
Prefix
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Telephone
Mobile
UNIVERSITY REGISTRATION INFORMATION
Name of University
University Website
Programme / Degree registered for
Upload Proof of Registration
Max. file size: 64 MB.
Application for membership must be accompanied by verification of enrollment in a full course of study, by an appropriate university official eg. Registrar.
DEMOGRAPHICS
Gender
Nationality
Country
Highest level of Education
Main area of Interest
Secondary area of Interest
Any other areas of Interest
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.
Name
This field is for validation purposes and should be left unchanged.

Student Membership