Membership Application Instructions

  • Please fill in all the required fields and as many of the optional fields as possible.
  • After clicking on the “Submit” button, you will remain on the same page and a message will appear to confirm your form submission. You will also receive an e-mail confirmation at the address you provided for your reference.
  • For any questions or technical problems please contact us.

    Title:

    Full Name:

    Applicant’s Position in Organization /Institution:

    Phone Number: -

    Fax Number: -

    E-mail Address:

    Organization or Institution:

    if other, please specify:

    Name of Organization/Institution:

    Organizational Website:

    Region:

    Country:

    Address:

    Street: City:

    Province/State: Country:
    Postal / Zip Code:

    Type of Organization /Institution:

    Type of Learners/Users:

    Number of users in your organization:

    Type of Participation:

    Period of Participation: