UEL Alumni Network Membership Application PERSONAL DETAILS Full name (incl. title): Date of birth: Graduation year: Student number: Qualification & subject: Full address (incl. post code): Home telephone: Mobile telephone: Email: Current occupation & employer: Family members who have studied at UEL: HOW DID YOU LEARN ABOUT THE UEL ALUMNI NETWORK? Friend UEL website Friends Reunited Graduation Ceremony LRC Student Information Students’ Facebook Other: ______________________ Centre Union ALUMNI NETWORK ACTIVITIES – PLEASE SELECT WHICH OPTIONS INTEREST TO YOU Lectures Reunions Networking Events Cultural Events Sporting Events Campus Tours Other: ____________________________________ VOLUNTEERING – HOW WOULD YOU LIKE TO GET INVOLVED WITH UEL? Form an Alumni Network group Help organise an event Give careers advice to students and alumni Participate in fundraising activities Offer paid placements to students/alumni Offer unpaid work experience to students/alumni Help out in the Development & Alumni Office Help at a graduation, open day or alumni event Other: __________________________________________________________________________________ ALUMNI PASSPORT SWIPE CARD (OPTIONAL) Please complete this section if you wish to apply for a Passport swipe card, which offers the following benefits: ‘Reader’ access to UEL’s libraries (Note: this does not include use of IT facilities or access to dissertations/theses, room bookings and short loan items) o Please note: An additional annual fee of £50 must be paid to UEL Library & Learning Services if you wish to borrow books from the libraries Discounted SportsDock membership rates, just take your card with you to the SportsDock when opening your new membership and you will receive the discount. (Prices subject to change) o Annual Payment – Gold £200, Silver £120, Bronze£20 o Monthly Direct Debit – Gold £30, Silver £20, Bronze £4 Access to the Students’ Union bars Access to the multi faith prayer room at Docklands campus Off-peak parking at Docklands and Stratford campuses The cost is a one off payment of £15 Instructions Complete this form and take to the UEL Docklands Campus Reception Building between the hours of 10:00 and 16:00. The team will aim to make your card on the same visit, however in some cases there may be a waiting period. Please ensure that you have included either a cheque made payable to UEL for £15 or full card details below □ I wish to make my £15 payment to UEL via credit/debit card. Note: All fields must be completed. Cardholder’s Name: Card Type (e.g. Visa, Maestro): Card Number: Issue Date: Expiry Date: Issue No. (if applicable): Security No. (last three digits on security strip): Note: All card payments will state “CHARITIES AID FOUNDATION” on your bank statement; this is the company we use to process payments. Disclaimer The UEL Alumni Network reserves the right to make changes to the criteria for and benefits of membership at any time. The UEL Alumni Network reserves the right to deny access to UEL and its facilities to an individual if they are a debtor, if they have been excluded from UEL, or for any other reason which comprises our health and safety policy. Membership is non refundable. UEL Data Protection Statement Your data will be used for a full range of alumni activities, including the sending of University publications, the promotion of benefits and services available to alumni, notification of alumni events and of programmes involving our academic schools and administrative services. It may also be used to provide you with information about further opportunities for study, activities and events that we feel may be of interest to you. We will only use it for the University of East London's own purposes, to inform you about its products and services, in accordance with our Data Protection Policy at (http://www.uel.ac.uk/essguide/part2/section_m.htm) and will not pass it to any third party, except where reputable contractors are used by the University to assist with particular alumni-related projects. Data may also be used in fund raising programmes which might include an element of direct marketing. Data Protection Act 1998 Under the terms of the Data Protection Act 1998 you have the right to object to the use of your data for such purposes. Please indicate below if you agree to your data being transferred to our Alumni Network and processed in this way when you graduate. Please also note that under the terms of the Act you may withdraw your consent to us using your data in this way at any future point. If you agree to become a member of the UEL Alumni Network now but change your mind at a later date please email: email@example.com asking for your record to be amended accordingly. You may use my data in this way: Signature: ........................................................... Date: ......................................................... Please return your completed form, together with your cheque payment, to University of East London, Alumni Development Office, Room WB 2.14, 4-6 University Way, London E16 2RD.
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