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Name / Seal of the Institution *
Address of Organisation *
Phone *
Fax
E-Mail *
Web *
Name of Person to be contacted *
Legal Status *
Established in *
Number of Centres *
Number of Language Learners p.a. *
Number of Teaching Staff (full time) *
Number of Teaching Staff (part time) *
Qualification of Teaching Staff *
Educational Aims *
Course Types *
Target Learners *
Language Programme *
Levels taught *
Certificates offered *
Other Memberships / Partnerships *
I / We wish to apply for Membership *Group of Institutes - EUR 500Single Institute - EUR 250Individual person - EUR 50
How did you hear about ICC Membership?Personal invitationWord of mouthInternetother
I / We agree with rights and duties as laid out in the articles of the association *