Institutional Membership Application
Please complete and send to Ms. Disha Kohli (d.kohli@iau-aiu.net)

1.	Applying Institution

Name of institution:
Official translation into English or French:					
Postal mail address:								
Country: 
Telephone:
Fax: 
General email:
Website:
Social media (Facebook, Twitter, etc.): 			

2.	Head of Institution					

Position (Rector, President, Vice-Chancellor etc.):
Title (Prof, Dr. etc):
First name: 		
Surname:
Gender (M/F) 
Phone: 
Email: 
Period of Mandate: from:   ..  / ..  / ….        to     ..  / ..  / ….         
Academic Discipline: 	

3. 	Head of International Relations	

Position:
Title (Prof. Dr. etc):
First name: 		
Surname:
Gender (M/F) : 
Phone:
Email: 

4. 	Contact person for Sustainable Development		

Position:
Title (Prof. Dr. etc):
First name: 		Surname:
Gender (M/F) : 
Email: 
Phone: 
	
5. 	Public Relations Officer

Position:
Title (Prof, Dr. etc):
First name: 			Surname:
Gender (M/F) 
Email: 
Phone: 	

5.	General Information:

5.1 Date of foundation and history of institution: 

5.2 Legal status of institution: 

 State Established University/Institution
 Private Not-for-Profit University/Institution
 Private For-Profit University/Institution
 Other, please specify:

5.3 Membership in national, regional and/or international associations:

6.  	Quality assurance or accreditation
Please explain the quality assurance or accreditation process undergone.

7.	Academic structure, degrees and diplomas

7.1 Academic structure (Please list the principal divisions (Faculties, Colleges, Schools, etc.): 

7.2 Indicate when the academic year starts and ends:
  
7.3 Principal qualifications awarded (Bachelors, Masters, PhDs, etc.) and period of study required for each: 

7.4 Number of degrees/diplomas awarded in each category:
Please fill in the number of degrees awarded for each of the diplomas/degrees listed above for the current year and past 3 academic years):

Category	Year:	Year: 	Year:	Current year:	

					
Etc.					

8. 	Academic staff 
Please indicate the number of academic staff for the current year and each of the past two years

Staff 	Year:	Year: 	Current year:	
Full time				
Part time				
Staff holding a doctorate				

9.	Student body 
For each category of qualification (Bachelors, Masters, PhDs, etc.), indicate the total student numbers for the current year and each of the past two years.

Number of students enrolled 	Year:	Year: 	Current year:	
Phd				
Master				
Bachelor				
Total				

10.	Research Facilities

10.1 Library holdings
- Number of volumes:			
- Number of periodical subscriptions: 
- Access to electronic networks (please specify):

10.2 Major research facilities:
Please list the equipment, laboratories, centres, etc

10.3 Major research output:
Please list the programmes, achievements, publications, conferences and seminars organized, etc
	
11.	Budget				

11.1 Total annual budget (in Euros or US Dollars): 

11.2 Percentage allocated for research: