Membership Registration Form

Membership Registration Form - Silver Level

Annual Membership
Benefits of Silver Membership

8 x tickets Analytics Institute monthly Inspire events
Speaking opportunities at our Inspire Events
Invite your customers / contacts to Analytics Institute events as special guests.
8 x Tickets to our National Analytics Summit
€600 Professional Certification Credit
Post your job vacancies on our Job Site
Promote your events to our members through our News section on our website
Promote your company's expertise by contributing articles to our Insights page on our website
Nominate staff / teams for our annual Fellowship & Industry Awards
Your logo on our homepage
Organisation Name
Contact Name

First Name Last Name
E-mail
Contact Number

Area Code Phone Number

Billing Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Starting Date for Membership

Day Month Year
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Silver Corporate Membership is €2,650 + vat
Payment Method *

Credit Card Bank Transfer

Membership Payment

Silver Level Annual Membership € 2,650.00 EUR

Subtotal € 0.00 EUR Tax € 0.00 EUR Total € 0.00 EUR

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Bank Transfer:

Allied Irish Banks University College Dublin, Belfield, Dublin 4.

Account: The Analytics Institute Limited

IBAN: IE69 AIBK 9301 5624 2070 60

BIK: AIBKIE2D
Once you have completed and submitted this form, please send a list of your team members to Roxane@analyticsinstitute.org.

There individuals will be placed on our Professional Register and will receive invitations and free tickets to all our events as members.

We require their names and email addresses. All data submitted in strictest confidence and will be held in accourance with our data privacy policies.
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