Affiliate Member Registration

Affiliates are individuals or organizations that want to maintain a direct “connection” with our work and help sustain its development. Basically, Affiliates aim to keep in touch through our Annual Report, and are willing to contribute financially in a supportive relationship with the institute.

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First Name
Last Name
Organization
Position
Street address
Street address 2
City
State/Province
ZIP / Postal code
Country
E-mail
Phone

Comments

Click on the button below to send your request. You will then be redirected to the payments page.

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[group organization-selected disable_on_hide]

Organization
Name of representative
Position
Street address
Street address 2
City

State/Province
ZIP / Postal code
Country
E-mail
Phone

Click on the button below to send your request. You will then be redirected to the payments page.

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