About AKRI : Join

Membership Application Form

(Please print out and send to us at the one on the following)

Mail Address:

Applied Knowledge & Innovation

Unit 12

Blackburn Technology Management Centre

Challenge Way

Blackburn

Lancashire

England

BB1 5QB

Fax:

++44 (0)1254 677533

The AKRI is a non-profit making organisation...

Contact Details

Company Name ...................................................................................................

Main Contact: ..................................

Position............................................

Address............................................

......................................................

Tel No:............................................

Fax No:............................................

email...............................................

2nd Contact: ...................................

Position...........................................

Address (If different).........................

.....................................................

Tel No:............................................

Fax No:..........................................

email...............................................

Website........................................

Business Details

Tick Box Manufacturing / Engineering

Tick Box AI Product Supplier

Tick Box Hospital/Medical

Tick Box Service Industry

Tick Box Food Industry

Tick Box Government Department

Tick Box Financial Services

Tick Box Education

Size of Company (number of employees)

Tick Box 0-50

Tick Box 50-100

Tick Box 100-250

Tick Box 250-500

Tick Box 500-1000

Tick Box 1000+

Tick Box Other (please specify).......................................

Member Type

I wish to join the AKRI as (select one)

Tick Box Company Member (£100 +VAT)

Tick Box Individual Member(£30 + VAT)

Tick Box Observational List Member (free information updates for 6 months)

Payment Method

Tick Box Please invoice my company

Tick Box II will send a cheque payable to "Blackburn College"

Please indicate how you heard about us

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