THE INSTITUTE OF MUSICAL INSTRUMENT TECHNOLOGY

The Hon. Secretary, I.M.I.T., Northfield House.
11 Kendal Avenue South, Sanderstead, Croydon, Surrey CR2 0QR

Application for admission as Member/Associate/Graduate/ Student/Companion.

PART 1 - To be completed by all applicants:

Full name....................................................

Full address................................................................................................... ..................
Post Code................. Tel: (Day)............................... (Eve)..................................
(these telephone numbers are for office use only, unless you enter them in Part 3)

Date of Birth.....................19.....
Branch(es) of music industry in which you specialise. Please indicate all areas (e.g. Piano, Organ etc)....................................................................... ................

Student applicants enter start and finish dates of College/University Course.

From........................... To.....................

PART 2 - For applications for all grades except Companion: I submit details of training, experience and status for consideration of the Council. The undersigned Corporate Members i.e. Member(s) or Fellow(s) support my application in accordance with the Memoranda and Articles of Association, Regulations and By-Laws of the Institute.

STATEMENT OF QUALIFICATIONS
(Please include relevant dates, and if more space is needed continue on a separate sheet).

(a) EDUCATION:

(b) TRAINING:

(d) PRESENT POST/RESPONSIBILITY/EMPLOYMENT STATUS (e.g. Self-employed )

Name and address of proposer (IN BLOCK LETTERS)

Signature........................................ Date.................

Name and address of seconder (IN BLOCK LETTERS)

Signature........................................ Date.................

In some instances candidates may not be able to obtain the necessary proposer or seconder from within the corporate membership (i.e. Members or Fellows) who are familiar with their present work. In such circumstances well established peers in the same discipline, such as an employer, work colleague, or a trade customer (such as a shop for whom work is carried out on a subcontract basis) maybe an acceptable substitute. Any combination of these options will be acceptable. In all cases permission must be sought and names and addresses of all proposers and seconders supplied as references will be taken up.

PART 3 - DECLARATION - to be signed by all candidates:

I declare that the information I have given is true. I hereby apply for enrolment as (please tick one category only):

Member

Associate

Graduate

Student

Companion

If I am elected, I agree to be governed by the Memoranda and Articles of Association, Regulations and By-Laws as they now stand or as they may from time to time be amended; that I will advance the objects of the Institute to the best of my ability, always providing that whenever I shall indicate in writing to the Secretary that I wish to resign from the IMIT, I shall, after payment of all dues, including those of the current year, be free from further obligation.

Signature........................................ Date....................
For candidates applying to upgrade, please enter existing roll number ......

For IMIT Directory purposes, the following information would assist the compilers:
Category of business (e.g.: Piano, Organ, Woodwind)

Special information which you feel would be helpful to other members:

Business telephone/fax number(s):

If you do not wish telephone information to be published in the IMIT Directory please place cross here......

Office use only:

Received by Secretary......................................	Presented to Council..........
Council decision..............................................	Further action....................
Result of further action....................................
Re-presented to Council..................................	Council decision..................
Registered number (if different from above)

Notes:

Table of Fees (Valid until 31 March 2009)

A separate cheque or Postal Order should be made out for (A) and (B).

(C) is optional, and should be added to (B) if you wish to order, but will be supplied only if your application is successful. If your application is unsuccessful, cheque B will be returned.

(A) Administration fee (non-returnable) £40.00
(this amount is an initial set-up, enrolment and investigation fee – -it is not required if you are already in the Institute and applying to upgrade to a higher category, nor is it required if you are applying for student or graduate membership.

(B) Applications for the following Categories must include the relevant fee:

(0):	Student (first two years)	Free
(1):	Student (from third year)	£16.50
(1a):	Graduate	£40.00
(2):	Associate	£40.00
(3):	Member	£40.00
(4):	Fellow	£53.00
(5):	Companion	£40.00
(6):	Retired	£20.50

(C) Institute tie and badge (special reduced price) £10.00

Please complete the following and send with your cheque(s) made payable to IMIT to: The Hon. Secretary, I.M.I.T.,
11 Kendal Avenue South Sanderstead Croydon Surrey CR2 0QR

Cheque 1
	(A) Administration fee (where applicable)	£
Cheque 2
	(B) Category of membership, please circle:
	(0) (1) (1a) (2) (3) (4)	Fee £
	(C) Institute tie and badge	£
Total		Cheque 1 £ Cheque 2 £
Final total		£