APPLYING FOR Associate Member (ACIPMA)
Full Member (MCIPMA)
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Honourary Fellow Member (Hon. FCIPMA)
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FIRST NAME
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COUNTRY
PHYSICAL ADDRESS
CITY/TOWN/STATE/COUNTRY
TELEPHONE (HOME)
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CELL/MOBILE
DATE OF BIRTH
PASSPORT NUMBER
IMPORTANT: PLEASE COMPLETE
By providing your e-mail address below, you will be indicating your consent to receive information on selected publications, events, seminar, trainings and service by e-mail from CIPMA and from third parties, unless you object to receive such messages by ticking the box below.
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I do not want to receive information by e-mail from CIPMA ; THIRD PARTY
Current Employer
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Telephone
Type of Business
Date first employed
No. of staff directly responsible to you
Present Position
Date Appointed
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