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    MEMBERSHIP FORM

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    PERSONAL INFORMATION

    Mr./Ms./Mrs./Miss/Dr.: Last Name:
    First Name: Middle Name: Suffix:
    Gender: Date of Birth:

    EDUCATION & PROFESSIONAL INFORMATION

    BACHELOR'S DEGREE Year:
    Course:
    University:
    MASTERALDOCTORAL Year:
    Course:
    University:
    OTHERS Year:
    University:
    License No.: Year:

    DATA PRIVACY

    Upon signing this form you are agreeing that the personal dataobtained from the registration form entered and stored within theInstitute’s authorized information and communications system and willonly be accessed by the IFPM authorized personnel. Furthermore, theinformation collected and stored in this form shall only be used for thefollowing purposes:

    • Announcements / promotions of events, programs, courses and otheractivities offered / organized by the Institute and its partners;
    • Activities pertaining to establishing relations withparticipants/members/alumni;
    • IFPM has the right to share your information to our related affiliatecompanies, institutions, and or subsidiaries;
    • IFPM shall not disclose the participants/members/alumni personalinformation without their consent and shall retain this information overa period of ten years for effective implementation, research analytics,and management.

    CONTACT INFORMATION

    HOME MAILING ADDRESS
    Home / Bldg. No., Street:
    City:
    Province: Postal Code:
    Phone Number:
    Mobile Number:
    Personal Email Address:
    BUSINESS MAILING ADDRESS
    Position:
    Company Name:
    Home / Bldg. No., Street:
    City:
    Province: Postal Code:
    Phone Number:
    Fax Number: (Country code/Area Code/City Code)
    Email Address:

    MEMBERSHIP TYPE

    ACCEPTANCE OF SUBSCRIPTION

    I declare that all of the information contained in this application is true and correct and I agree to provide any supporting documentation requested bythe Institute. If accepted, I agree to abide by the International Federation of Professional Managers’ Code of Professional Conduct and ContinuingProfessional Education requirements. I understand that I must renew my subscription annually to enjoy the services provided by the Instituteincluding eligibility privileges and retention of professional designation.
    Digital Signature:
    Date:

    Please double check your PERSONAL EMAIL if correct before submitting the form.
    Confirmation email will be sent there.