THE
INSTITUTE OF INTERNATIONAL LICENSING PRACTITIONERS*
*
A
company limited by guarantee.
Applicants full Name:
Title and description of
Applicants firm or business and address:
Telephone No:
Fax:
E-mail:
How did you learn of the existence of the
IILP?
..
Name and address of Applicants bank:
Applicants relevant academic and / or professional qualifications:
How long has the Applicant been engaged in licensing:
a)
as an independent practitioner?
b)
in any other capacity?
Countries
in which the Applicant has:
a)
direct licensing experience?
b)
branch offices or associates?
Industries
in which the Applicant has licensing experience:
Manner in which the Applicant charges for services (please tick Φ
as appropriate):
(
)
1. Specific or
time-based, estimated in advance
(
)
2. Time-based,
accounted for during project
(
)
3. Speculative basis
and either 1 or 2
(
)
4. Speculative basis
only
* A company limited by
guarantee.
Names and address of two clients to whom reference may be made about
Applicants licensing work:
3.
Applicants for Affiliate Membership only
Applicants
principle area of professional / commercial activity:
..
..
Applicants
reasons for wishing to have links with the
IILP (please
state fully)
.
.
.
.
Name and address of character
reference:
.
.
..
.
Name and address of one client/customer to whom reference may be made
about applicants principle area of activity:
·
Fellowship, Associate Membership and Affiliate Membership is open to
Individuals only.
·
Entrance Fee currently is £45.00
for all classes of membership.
·
Annual subscription currently (January - December) is:
Fellows
£95.00 *
Associate Members
£95.00 *
Affiliate Members
£85.00 *
·
The Executive Committee, under the Articles of Association of the
Institute, has complete discretion to accept or reject any application for
Fellowship, Associate Membership or Affiliate Membership
and is under no obligation to give any reason for its decision.
·
Applicants are requested NOT to send their entrance fee or annual
subscription until they have been notified of their election.
Declaration
to be signed by Applicant
To:
The Membership Secretary
The Institute of International Licensing Practitioners
Oxford Centre for Innovation, Mill Street, Oxford OX2 0JX, England
I herewith apply for
election for Fellowship/Associate Member/Affiliate Member of the Institute of
International Licensing Practitioners and I request you to place my application
before the Executive Committee at its next meeting. In support thereof I submit the above information which
to the best of my knowledge and belief is accurate and true.
I have read both the Summary of the Memorandum and Articles of Association
and the complete Code of Conduct and I hereby agree in the event of my election
to be governed by the said Memorandum and Articles and by the Code of Conduct as
these documents are now constituted or as they may hereafter be amended.
Signed:.......................................................................
Print name
.
..
Date:....................................................................................
Please use your browser's print facility to print this form. Alternatively click this link to obtain the form in Acrobat format. When you have completed it, please post it to the Membership Secretary