Membership Form – WORLD ACADEMY OF ISLAMIC MANAGEMENT

Membership Form

First Name

Last Name

Gender

Date of Birth

Nationality

IC or Passport No

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Occupation

Membership type

My Reason is:

I declare that the information supplied in support of my application for membership is to the best of my knowledge, true and correct.