Euro GPR - Application - Individual Membership

Application - Individual Membership

Name of organisation (if appropriate):
Name of main contact or individual:
Give your name if different to that above:
The names of up to five other representatives you wish to nominate (these people then have the right to attend meetings)
Full address:
Telephone Number:
Fax Number:
E-mail address:
Web site:
Type of organisation (e.g. Company, Partnership, University, Individual):

Please note: we also require extra information regarding your application. You can supply this information along with your payment by post to: Erica Utsi Treasurer European GPR Association c/o Utsi Electronics Sarek Newton Road Harston Cambridge. CB2 5NZ United Kingdom	A Date of first involvement with GPR B Nature of current employment (eg Academic, Retired) C Provide a brief resume of your background and current work with GPR, if any. (This may be provided in the form of a CV)