Join Alumni Form

THE UNIVERSITY OF THE WEST INDIES ALUMNI ASSOCIATION BARBADOS CHAPTER (formerly GUILD OF GRADUATES) P.O. Box 64, Bridgetown, Barbados BB 11000 Office Hours: Saturdays 2:00 pm – 6:00 pm Telephone: (246) 417-4577 Email: [email protected]

MEMBERSHIP APPLICATION FORM NAME:

____________________________________________________________________________

ADDRESS:

____________________________________________________________________________

TELEPHONE NO.(H)

_______________________________ E-MAIL ADDRESS ________________________

MARITAL STATUS

_______________________________ NO. OF CHILDREN ________________________

OCCUPATION

____________________________________________________________________________

COMPANY NAME

________________________________ TELEPHONE NO (W) ______________________

COMPANY ADDRESS

_____________________________________________________________________________

ACADEMIC QUALIFICATIONS: UNIVERISTY OF THE WEST INDIES QUALIFICATIONS: CERTIFICATE: Year/Faculty)___________________________________________________________________ DIPLOMA (Year/Faculty)_______________________________________________________________________ BA/BSC (Year/Faculty) ________________________________________________________________________ MA/MSC (Year/Faculty) _______________________________________________________________________ PHD (Year/Faculty) ____________________________________________________________________________ OTHER QUALIFICATIONS:

______________________________________________________________________

EXTRACURRICULAR ACTIVITIES AND SKILLS YOU COULD OFFER THE ASSOCIATION: _______________________________________________________________________________________________________ MEMBERSHIP IN OTHER CLUBS AND ORGANISATIONS:

OFFICE USE ONLY DATE:

SIGNATURE OF UWIAA OFFICER:

_______________________________________________________________________________________________________ ANNUAL FEE PAID SIGNATURE OF APPLICANT: ($50.00)

________________________________________________________________