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Membership Number (on previous membership certificate) |
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| Name | |
| Professional Title (exact) | |
| Please insert any changes to your contact details and employment position below, otherwise leave blank | |
| Home address Telephone |
Work address (if appropriate)
Telephone |
| Present post | |
| The Association runs a database of members on its website. This is available to all other members, but not the general public. If you would like to be included on it, tick the appropriate boxes below. |
| Tick here to include your details in the database | |
| Address | |
| Home Phone | |
| Mobile Phone | |
| Work Phone | |
| Work Fax | |
Fees: £20.00 for salaried members e.g. Full/Associate or even Student (when student is on a salary). £10.00 for unwaged members e.g. Retired members or Students not on salaries of any kind. Half of the fee will be returned to your local group. It is not possible to belong to a local group only Name of local group: I agree to the rules of the British Association of Educational Audiologists as set out in the constitution I enclose a cheque for £20.00 / £10.00 made payable to BAEA Signed: Date: Please print and return to the membership secretary at the above address |