GAILA Membership Application

Layout

Institution’s Legal Name *

Postal code

Email address *

Registered Address *

Telephone Number(s)

Website URL

Layout

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

Layout

Name *

Email *

Representative for General GAILA Communication Purposes

Layout

Name *

Email *

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

Layout

Name *

Email *

Reason for wanting to join GAILA *

Name of person completing membership application *

Email *