Application for Membership of the British Federation of Women Graduates - BFWG

SECTION 1: MEMBERSHIP

Please tick one option in the line belowIf completing this form electronically, copy and paste to show your options

I am joining as a member of the Local Association named below:

I am joining as an Independent member associated with the Region ticked below:

……………………………………….. Association

Northern Eastern

Mercia, Wales & West

Category of Membership

See Section 6 for cost of subscription

Please tick one option below

OrdinaryJuniorAffiliate

5-yearRe-joiner

If Junior please give anticipated date of 2nd degree (if applicable).

Please tick here if in receipt of

Scholarship Trust award in year of joining

SECTION 2: PERSONAL & CONTACT DETAILS –

Please refer to the BFWG Privacy Policy: https://bfwg.org.uk/bfwg2/privacy-and-cookie-policy/

Title (Dr/Prof/Ms etc.)

Forename(s)

Surname

Known as (if different)

Date of birth

Address

Postcode

Tel no (home)

Tel no (work)

Tel no (mobile)

E-mail address

SECTION 3: EDUCATION

First degree

Year of graduation

Awarding Institution

Subjects

Post-graduate degree(s)

Year(s) awarded

Awarding Institution(s)

Subjects

SECTION 4: QUALIFICATIONS AND OCCUPATION

Professional qualifications

Other qualifications

Occupation. If retired, indicate and state previous occupation.

SECTION 5: FURTHER INFORMATION

(Optional – you are invited to specify areas of special interest or expertise to BFWG)

How did you hear about BFWG?Website Personal recommendation Other

SECTION 6: FEES

Introductory joining fee for an Ordinary member in her first year -£40

Subscription for second and subsequent years -£57

Five-year membership -£270

Junior member (postgraduate students and up to two years after graduation) -£40

Affiliate membership (for members of other International Federations) -£40

Scholarship Trust award winner - first year fee waiver- £nil

Some Local Associations charge a small additional local fee, to be paid locally.

SECTION 7: RETURNING THIS FORM AND MAKING PAYMENT

· To join as a member of a Local Association: return your completed form to the Membership Secretary or Treasurer of the Local Association named in Section 1 with your cheque made payable to BFWG , e.g. BFWG Winchester Association;

· To join as an Independent member:

(a) return your completed form to the BFWG Office with your cheque made payable to BFWG; or

· (b) email the application form to office@bfwg.org.uk and pay your subscription fees online by PayPal or

Online: sort code 50 – 21 – 01; account number 66725852; bank: Nat West, Clapham Junction branch. Ensure you enter your name in reference so we can match payment.

I have paid £ by Cheque PayPal Bank Transfer

(please fill in amount paid and tick to indicate payment method as appropriate)

PayPal Reference:

Signed:

Date:

Please tick to confirm agreement to the British Federation of Women Graduates Privacy Policy

FOR BFWG ASSOCIATIONS USE ONLY

Date form received

Date local information sent

Date copy sent to BFWG Office

This form can be downloaded from www.bfwg.org.uk and completed in WordTM

The above details are held on the BFWG database in accordance with the Data Protection Act

BFWG HQ, 4 Mandeville Courtyard, 142 Battersea Park Road, London SW11 4NB

Email: office@bfwg.org.uk • Website: www.bfwg.org.uk