Organizational Membership Application
Please complete and return to Ms. Disha Kholi (d.kohli@iau-aiu.net)

1.	Applying Organization
Name of Organization
Acronym:
Postal mail address:								
Country: 
Telephone:
Fax: 
General email:
Website:			

2.	Executive head of the Organization	(main contact)				
Position (Secretary General, President etc.):
Title (Prof, Dr. Ms. Mr. etc.):
Name:
Gender (M/F) :
E-mail: 
Phone: 
Period of Mandate if applicable: 

3. 	Deputy (second contact)	
Position:
Title (Prof, Dr. Ms. Mr. etc.):
Name:	
Gender (M/F) : 
E-mail: 
Phone: 
				
4. 	Public Relations Officer 
Position:
Title (Prof, Dr. Ms. Mr. etc.):
Name:
Gender (M/F) : 
E-mail: 
Phone: 	

5. Date of foundation and brief history of the organization:

…

6. Legal status of the organization:  

…

7. Governing structure:

…

8. Mission and main activities:

…

9. List of members (or link to online list of members):

…

By completing this form, you agree to submit your data to the International Association of Universities. You will find all the information relating to the use of your data in our privacy policy: https://iau-aiu.net/Terms-of-use. For any consultation, modification and / or deletion of your data, please send your request by email to iau@iau-aiu.net