Mrs Margaret Ballardie

ICOM UKMEMBERSHIP RENEWALS 2014

PLEASE complete both pages of this form and send it with your payment to the ICOM UK Administration at the above address:

SECTION A: INDIVIDUAL MEMBERS

Name: / Membership Number:
Job title: / Department:
Institution:
Delivery address for sticker:
Personal email address:
For Individual Members: Date of Birth

TICK ONE

Individual regular member / £70.00 / 
Student/retired member / £33.00 / 

INTERNATIONAL COMMITTEES

List ICOM International Committees of which you are a voting member (refer next page)

List ICOM International Committees of which you are a non-voting member (refer next page)

SECTION B: INSTITUTIONAL MEMBERS

Contact name: / Membership Number:
Job title: / Department:
Institution:
Delivery address for sticker:
Contact email address:

TICK ONE

Operating budget less than £30k per annum / £270
Operating budget £30k – £100k per annum / £335
Operating budget £100k – £1m per annum / £498
Operating budget £1m – £5m per annum / £598
Operating budget £5m – £10m per annum / £681
Operating budget in excess of £10m per annum / £832

INTERNATIONAL COMMITTEES

List ICOM International Committees of which you are a voting member (refer below)

List ICOM International Committees of which you are a non-voting member (refer below)

SECTION C: ALL RENEWING MEMBERS

Method of payment

I enclose my cheque made payable to ICOM UK / 
I have paid my 2014 membership fees by BACS transfer to: Bank: Natwest/ Branch: Woodstock Account Name: ICOM UK / Account Number: 07047606/ Sort Code: 55-81-35.
Please note the date of transfer here ...... and please use your MEMBERSHIP NUMBER and SURNAME OR INSTITUTION NAME as payment reference. / 
Please send me an invoice / 
Institutions and individuals please send this form as remittance advice with full payment details to the address at the top of the form.

Signed:……………………………………………… Date:……………………………

I confirm that the information above, with any amendments I have made, is correct.

I confirm that the ICOM UK Committee may store the information I have provided in a database, and share it with the ICOM Secretariat, for the purposes of administering my membership.

ICOM International Committees

AVICOM – Audiovisual / ICLM – Literary Museums
CAMOC – City Museums / ICMAH – Archaeology and History
CECA – Education/ Cultural Action / ICME – Ethnography
CIDOC – Documentation / ICMEMO – Memorial Museums
CIMAM – Modern Art / ICMS – Museum Security
CIMCIM – Musical Instruments / ICOFOM – Museology
CIMUSET – Science and Technology / ICOM-CC – Conservation
CIPEG – Egyptology / ICOMAM – Arms and Military History
COMCOL – Collecting / ICOMON – Money and Banking Museums
COSTUME – Costume / ICR – Regional Museums
DEMHIST – Historic House Museums / ICTOP – Training of Personnel
GLASS – Glass / INTERCOM – Management
ICAMT – Architecture/ Museum Techniques / MPR – Marketing and Public Relations
ICDAD – Decorative Arts and Design / NATHIST – Natural History
ICEE – Exhibition Exchange / UMAC – University Museums and Collections
ICFA – Fine Arts