You may use this form to apply for or renew 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
SelectEasternEast MidlandsHome CountiesLondonNorth EastNorth WestNorthern Ireland BranchSouth EastSouth WestWalesWest Midlands
Membership Type
SelectAssociateFullFellow(Rnwl)Companion(Rnwl)Standard-OrganisationMedium-OrganisationLarge-Organisation * 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