a non-members application form - Association of Business Executives

Application for Associate Membership (AMABE)Non-ABE MembersAssociate Membership may be awarded by direct entry to non-ABE members who are:► Lecturers with 1 year’s experience teaching ABE programmes (complete Sections 1, 2 & 4) OR► Mature applicants with 5 years work experience, and must be at least 28 years old(complete Sections 1, 2 & 4) OR► Holders of a recognised MBA qualification (complete Sections 1, 3 & 4)APPLICATION FOR MEMBERSHIP (AMABE) MUST BE ACCOMPANIED BY APPROPRIATECONFIRMATION FROM YOUR EMPLOYER(S) OR COPY OF MBA CERTIFICATE1. Personal DetailsDate of Birth:Full Name:Address:Country:Tel:Fax:Email:2. Employment DetailsApplicants are required to submit appropriate evidence of employment.Present employmentCompany Name:Job title:Address:Date of employmentFrom:To:Past employmentCompany Name:Address:Job title:Date of employmentFrom:To:3. Educational DetailsApplicants applying for AMABE membership with a recognised MBA qualification MUST submit a copy oftheir MBA Certificate and transcript of results with this application form.I will be submitting the following qualification:Qualification Awarding Body Grade Date Awarded

4. Payment DetailsBy direct entry: £50Please tick appropriate boxI enclose a Sterling Cheque/Postal Order/Banker’s Draft for £Payment must be made by £ sterling cheque/draft drawn on a UK bank – Payable to ‘ASSOCIATION OF BUSINESSEXECUTIVES’.Please deduct from my Credit Card* (complete credit card section below)*CREDIT/DEBIT CARD PAYMENT FORMI wish to pay by:I authorise you to debit my account with the amount of £ VISA Delta MasterCardMaestro Solo JCB AMEXMy card number isSecurity CodeExpiry date Valid from Issue no. (last three digits on signature strip on backMonth Year Month Year (If applicable) of card or four digits on front of AMEX card)IMPORTANT NOTEYOU MUST GIVE THECardholder NameSECURITY CODE FORPAYMENT TO BEACCEPTEDCardholder AddressPostcode (UK address only)Telephone no.Fax no.Email addressCardholder SignatureStudent’s Signature (if not cardholder)DateDate5. DeclarationI certify that the information given in this application is true and I agree to comply with the regulations ofThe Association. I enclose letter from my employer/copy of MBA qualification and fee of £50.SignatureDateChecklist - Have you enclosed?The Direct entry feeCopy of MBA qualification/Letter of reference from your current employer stating length and status of yourwork experience.Send to:The Association of Business Executives5 th Floor, CI Tower, St. Georges Square, High Street, New Malden, Surrey, KT3 4TE, UKt: +44 (0)20 8329 2930 f: +44 (0)20 8329 2945 e:registration@abeuk.comwww.abeuk.com