AISM Global Online Membership Application Form


APPLYING FOR* : ASSOCIATE MEMBER
FULL MEMBER
FELLOW MEMBER
HONORARY MEMBER
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 AISM 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
AISM: 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 AISM as they are now, and as they may from time to time. * :
I accept:
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