GAILA Membership Application

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Institution’s Legal Name *

Email address *

Registered Address *

Website URL *

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Date Founded *

License Issued By *

Financial Status:

Date License Issued *

attach a copy of the license *

Click or drag a file to this area to upload.

Legal Representative of the Institution

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Name *

Email *

Head of School/Chancellor/CEO/General Manager/etc. of the Institution

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Name *

Email *

Reason for wanting to join GAILA *

Name of person completing membership application *

Email *