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Membership Form

The Chief Executives' Club at Queen's

Membership Application Form

I would like to become a Member of the

Chief Executives’ Club at Queen's


This information is held by the Chief Executives' Club at Queen’s and is not shared with any other organisation or department either internal or external to Queen’s University.

* Fields marked with an asterisk are required.

Title:
* Name:
Position:
Company:
Address:  
Postcode:
PA/Secretary:
Telephone:
Fax:
Mobile:
* Email:
Web:
Special Diet:

 

An invoice for £185, to cover membership until 31 July 2014, will be issued upon receipt of your membership application.

If you have any queries, please contact Brenda Carabine at 028 9097 1153 or brenda.carabine@qub.ac.uk.

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