BEAI on-line membership application form
Membership category applying for
Full member �30
Associate member �20
Retired member �20
Student member �10
Corporate member �300
Surname
First Name
Membership number (renewals only)
Proposed by (new members)
Seconded by (new members)
Position
Facility / Company
Contact address
Telephone number
Fax number
Mobile number
E-mail address
Area/s of interest
Can BEAI forward your details to interested
parties?
Yes
No
Comment/s
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