Member Application Form

SECTION C: EMPLOYMENT STATUS and OTHER INFORMATION:
Occupation/Job Title*
EMPLOYMENT STATUS*
State nature of Business*
Name of Employer/Business/School:*
Telephone No.:*
Employed/Attending School Since (dd-mm-yyyy):*
Date Format: MM slash DD slash YYYY
Employer/Business/School Address:*
Street Address Address Line 2 City/Town/District: State / Province / Parish P.O. Box/Postal Zone Country
Expected Deposit :*
- Annually
- Monthly
- Fortnightly
- Weekly
Amount*
Source of funds:*
Currency:*
Do you or your immediate family (parents, siblings, spouse, children, step children, in-laws) and close associates hold or has held any of the following positions locally or internationally? #Member of the Judiciary Military official above the rank of Captain Member of the police of or above the rank of Assistant Commissioner #Head of State Head of Government Minister of Government Member of any house of Parliament Official of any political party Director or Chief Executive of any company in which the Government owns a controlling interest Senior management position in an international organization and/or Permanent Secretary Chief Technical Director or Chief Officer in charge of the operations of a Ministry, department of Government, Executive Agency or statutory body as the case may be.*
- Yes
- No
If yes please explain: .......

INTRODUCTION