You may use this form to register your interest in applying for or renewing Membership of the Institute of Licensing
Membership Application
Full Names
*
Job Title
Tel No
Email
Organisation
Type
SelectGovernment BodyLocal AuthorityPoliceSolicitor FirmBarristerLicensing ConsultantTrade AssociationOther
Other
Existing Member
SelectYesNo
Institute Region
SelectLondonSouth EastHome CountiesEasternSouth WestWest MidlandsEast MidlandsNorth WestNorth EastWalesNorthern Ireland Branch
Membership Type
SelectAssociateFullFellowCompanionOrganisationalNon-member * Click here for more information
Business address including postcode
Business Telephone number
Business Email Address
Fax Number
Invoice organisation if different
Invoice address if different
all boxes marked '*' must be completed