EuroGPR membership application

Membership type: *
Name of organisation (if appropriate):  
Name of main contact or individual: *
Give your name if different to that above:  
Enter the names of up to five other representatives you wish to nominate, these people then have the right to attend meetings and, if their email addresses are included, be subscribed to the mailing list and discussion forum.  
Name #1 :

 
Email #1 :

 
Name #2 :

 
Email #2 :

 
Name #3 :

 
Email #3 :

 
Name #4 :

 
Email #4 :

 
Name #5 :

 
Email #5 :

 
Registered office address: *
Telephone Number:  
Fax Number:  
E-mail address: *
This field is required if you would like an optional weblink. If you do not require a weblink, entering a website is still recommended as it may speed up your application approval.  
Web site:  
Please indicate whether you would like the option of a weblink to your website from the EuroGPR website (additional £25 per year)  
Type of organisation: *
If you carry-out GPR surveys in the UK you are required to posses an GPR operator's licence.  Please provide the details of your licence if required.  
OfCom Licence No:  
OfCom Licence Expiry Date:  
Does not carry out GPR surveys in the UK  
Provide a résumé of your organisation's activities and work with GPR. This information will help with your application. We recommend around 100 words. *
Please provide the name and email address'/phone numbers of two referees. The referee should be a client or someone recognised within the GPR industry, ideally already a member of EuroGPR. Please agree this in advance with your referee. For academic institutions or individuals, references to peer reviewed publications may be entered instead. *
Please confirm you have read and understand the Code of Ethics and Memorandum of association  
Promotional code: