REFERENCE The Institute values reference letters that dwell on specifics about the applicant, rather than on generalities. Since this is an important part of your application, select a referee who can give an accurate account of your professional development. Registrar Zambia Institute of Marketing P.O Box 32180 LUSAKA. Email: zim@iconnect.zm MEMBERSHIP APPLICATION FORM All information given in this form will be strictly confidential. Typed written applications are preferred, otherwise use capital letters. SECTION I: PERSONAL DETAILS I. Surname: II. Title: Prof./Dr./Mr./Miss ..Other Names: .
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VII. Business Address VIII. Business Telephone IX. Email: X. Current Job Title
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II.) Are you already a member of other professional bodies? Yes . No . If yes, please give details:
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DECLARATION
I hereby declare that the information contained in this application is correct, to the best of my knowledge.
SIGNATURE OF APPLICANT
DATE
ZIM IS A PROFESSIONAL BODY THAT DOES NOT DISCRIMINATE ON THE BASIS OF RACE, CREED, SEX, ETHNIC ORIGIN OR HANDICAP.