Application for Associate Membership of Keble MCR

I. Personal information
Title (Mr/Mrs/Miss/Ms etc.):
Family Name / Surname:
Forename(s):
Date of Birth (dd/mm/yyyy):
Telephone:
Email:
Address:
II. Please indicate the category of Associate Membership applied for
1. Former full member of Keble MCR.
2. Former associate member of Keble MCR who is a registered at Oxford University
3. Member of the College reading for a higher degree, postgraduate diploma, or postgraduate certificate or attending the Overseas Service Course.
4. Member of the College engaged in an undergraduate course of study and in your fourth or higher year of study.
5. Member of the College who at the time of undergraduate study is significantly older than the average age of fellow students in the same year of study.
6. Member of the College with the status of Senior Student according to the provisions of the
Examination Decrees.
7. Official Visiting Research Scholar granted graduate dining and library rights by the College and recommended for Associate Membership of the MCR by the Senior Tutor of the College. Associate Membership granted in this way shall only last while the College extends such rights.
8. The spouse or partner of a full member of Keble MCR
NB: No personal card access to the MCR. Associate members in category 7 may enter the MCR when accompanied by any MCR member with card access.
IV. Recommendation by the Senior Tutor - only necessary for membership category 6 (official Visiting Research Scholar)
The applicant has been recommended by the Senior Tutor on request from the following college fellow:
III. Nomination by current full member of the Keble College MCR – only necessary for membership category 1 (former MCR Member)
Former full members of the Keble MCR have to be nominated by a current full member of the
MCR for associate membership. NB: The nominee is responsible for the associate member when he/she is on college property.
I recommend ...... for Associate Membership of Keble College
MCR.
Name / Date / Signature
V. Subscription period for Associate Membership – check the appropriate box or boxes
Whole Year (£40) / Michaelmas Term (£15) / Hilary Term (£15) / Trinity Term (£15)
If you are a Category 6 applicant (Official Visiting Research Scholars) please indicate the period of your college membership:
VIII. Note
By signing I state that I am familiar with the MCR Constitution and College regulations. I will treat other members of the MCR and their guests with respect and will care for the facilities used. I understand that I may be battled for additional costs (e.g. use of the MCR cellar or attending Black Tie Dinners) or that I will pay these costs by other means as soon as possible.
IX. Applicant signature
Name / Date / Signature
VI. Information needed for swipe card access to the MCR
University Card number:
Bodleian Readers Card (for applicants without a University Card):
VII. Additional services – see separate form. Only for former full members who completed a D.Phil at Keble, are currently postdoctoral research assistants at the University of Oxford, and are not Senior Members of another college.

The deadline for Associate Membership Applications is Monday of Week 1 of the term in which you are applying.

For official use only.

Date of entry
Accepted by MCR Committee / Yes / No / Date:
Membership fee paid / Yes / No / Date:
Swipe card access / Forward to IT Office / Date:
Additional rights / Forward to Bursar's Office / Date: