IPMA Nigeria Online Membership Application Form

IPMA Nigeria Online Membership Application Form

APPLYING FOR* :

DIPLOMA
HIGHER DIPLOMA
PROFESSIONAL POST GRADUATE DIPLOMA
EXECUTIVE MASTERS
STUDENT MEMBERS
NYSC MEMBERS
ASSOCIATES
FULL MEMBERS
FELLOWS

SURNAME* :

FIRST NAME* :

POSTAL ADDRESS* :

COUNTRY* :

PHYSICAL ADDRESS :

CITY/TOWN :

POSTAL CODE* :

TELEPHONE (HOME) :

TELEPHONE (WORK) :

CELL/MOBILE :

DATE OF BIRTH* :

PASSPORT NO. :

IMPORTANT: PLEASE COMPLETE
By providing your e-mail address below, you will indicating your consent to receiving information on selected publications, events seminars, training and services by e-mail from IPMA and from third parties, unless you object to receiving such messages by ticking the boxes below:

E-mail* :

I do not want to receive information by e-mail on events and service from
IPMA : Third party :

Current employer :

Address of organization :

Tel. Phone No :

Types of Business :

Date of first employed :

No of staff directly responsible to you :

Present position :

Date appointed :

EDUCATIONAL INFORMATION* :

Professional training information :

Declaration: I declare that the statement made herein are correct to the best of my knowledge and belief, and that I agree to be governed by any bye-law/regulations and code of conduct of IPMA as they are now, and as they may from time to time. * :
I accept:

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