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a non-members application form - Association of Business Executives

a non-members application form - Association of Business Executives

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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 <strong>of</strong> £ 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) <strong>of</strong> card or four digits on front <strong>of</strong> 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 in<strong>form</strong>ation given in this <strong>application</strong> is true and I agree to comply with the regulations <strong>of</strong>The <strong>Association</strong>. I enclose letter from my employer/copy <strong>of</strong> MBA qualification and fee <strong>of</strong> £50.SignatureDateChecklist - Have you enclosed?The Direct entry feeCopy <strong>of</strong> MBA qualification/Letter <strong>of</strong> reference from your current employer stating length and status <strong>of</strong> yourwork experience.Send to:The <strong>Association</strong> <strong>of</strong> <strong>Business</strong> <strong>Executives</strong>5 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

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