IAIDQ--membership

Membership:

Change of membership details form:

Note: This form is not encrypted; details will be sent to our office by email.

Use this form to advise our office of change of any details. You must provide provide either your membership number or old email address so that we can identify you in our database.

If you change your email address and/or password, we will change your access to the members zone and advise you when the change is made.

Group	Detail	Response
Membership	Membership number **	- - e.g. 000-123-1
Name	Given name *
	Name known as (if different)
	Surname/ family name *
Address	Address line 1
	Address line 2
	Town / city
	State / Province / County	Australia/Canada/USA: Other countries:
	Postcode / ZIP code
	Country
	Address type	No change Business Home
	Old Email **
	New Email (leave blank if no change)
	Alternate Email (in case your first email changes)

Telephone details	Country code	e.g. 1 USA/Canada, 44 United Kingdom
	Phone number	include area code, e.g. 713 456 7890 or 02 3456 7890
	Mobile phone
	FAX
	Skype address

Employment	Organization name
	Job title
	Job function
	Seniority within organization
	Experience--year you commenced IQ

Students	University / School name
	Registrar phone &/or email

Privacy	Privacy guidelines

Membership category	Definitions

Members zone	Password for web access

Message to IAIDQ office


* mandatory field you must enter at least one item marked