NIGERIAN INSTITUTE OF MANAGEMENT
(CHARTERED)

MEMBERSHIP UPGRADING FORM

ONLINE REGISTRATION
 
Membership Number:    
Current Grade:    

Date Admitted To
Current Grade:
e.g. yyyy-mm-dd

   
 
Teller Number:

Amount Paid:

Name of Bank:

Date of Payment: e.g. yyyy-mm-dd

 
Surname (In full):    
Other Names (In full):    
 
current Postal Address:    
State of Origin:    
Date of Birth:
e.g. yyyy-mm-dd
    
Telephone:

Mobile (GSM):

E-mail Address:    
Profession e.g. Engineering, Law, Teaching etc.    
Preferred Induction Venue:: select your choice    
 
Institution(s) Attended
NAME OF INSTITUTION:

QUALIFICATION OBTAINED:

YEAR:

1.


2.

 
Current Work Experience
NAME OF ORGANIZATION:

ADDRESS OF ORGANIZATION:

POSITION HELD:

YEAR:

 
Previous Work Experience
NAME OF ORGANIZATION:

ADDRESS OF ORGANIZATION:

POSITION HELD:

YEAR:

1.


2.

 
  NOTE: Check carefully all the details / enteries you have entered above for correctness before clickng on the SUBMIT button below, this is because correction would not be possible afterwards

 
  Very Important: P L E A S E, click on the SUBMIT DATA button only ONCE, and wait till the next page that displays your records appears.