Application for membership of IFA Nigeria Branch – please print complete and send to membership@ifa-nigeria.ng
Alternatively you can download a copy:
APPLICATION FORM
IFA NIGERIA BRANCH
___________________________________________________________________________
(Please TYPE)
SURNAME *) : ______________________________________________________
TITLE (e.g. Prof., Dr): _____________________________________ Mr / Mrs / Ms
FIRST NAME(s) **) : ______________________________________________________
MAILING ADDRESS :
(firm/company) ______________________________________________________
Street/No or P.O.Box : ______________________________________________________
City : ______________________________________________________
Country : ______________________________________________________
TELEPHONE : _________________________ FAX:________________________
E-MAIL : ______________________________
DATE OF BIRTH : ______________________________
(dd-mm-yyyy:)
Application for : individual / corporate membership (please circle)
*) In case of corporate membership please fill out: Company name
**) In case of corporate membership please fill out: Representative(s)
Educational : ______________________________________________________
Qualifications ______________________________________________________
Publications : ______________________________________________________
______________________________________________________
Professional : ______________________________________________________
Memberships ______________________________________________________
Please enclose TWO letters of recommendation by IFA members
Membership fee 2020:
Individual Membership : N65,000
Corporate Membership : N135,000
Individual/Corporate membership fee 2020 (please circle relevant item)
Please sign and forward form and enclosures to:
IFA NIGERIA BRANCH
c/o ǼLEX Tel.: (+234-1) 4617321-3
4th Floor, Union Marble House E-mail: lagos@aelex.com
1, Kingsway Road, Falomo, Ikoyi
Lagos, Nigeria
DATE: ______________________ SIGNATURE: _____________________