ZIM Fellow Membership Application

Applicants for Fellowship must have been active Full members of the Institute for not less than TEN (10 years)

Personal Information

Title

Name *

First

Last

Date of Birth *

NRC Number *

Phone Number *

Email *

Confirm Email

Business Address *

Address Line 1

City

State / Province / Region

Country

Residential Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Attachments

Provide CERTIFIED copies of Certificates and detailed CV

Upload Detailed CV *

Click or drag a file to this area to upload.

Upload Certificate *

Click or drag files to this area to upload. You can upload up to 5 files.

Upload Proof of Payment of K100 Application Fee *

Click or drag a file to this area to upload.

Deposit Slip/ Transfer Slip

Professional And Academic Qualifications

Positions And Organisations *

Work Experience

1. Marketing Practice At Senior Level *

NOTE: Marketing Practice experience is when one has practiced Marketing for at least ten years.

Number of Years *

2. Marketing Consultancy (Optional)

NOTE: Marketing Consultancy experience is when one has Lectured or taught at a University, College or Institute for at least ten years.

Marketing Consultancy # of Years

3. Marketing Research (Optional)

NOTE: Marketing research is when one has engaged in Marketing research or related fields for at least ten years.

Marketing Research # of Years

4. Community and Professional Activities (Specify) *

Community and Professional Activities *

Professional Attainments

Provide a comprehensive write up that must be endorsed or authenticated by the supervisor

Upload Write-up *

Click or drag a file to this area to upload.

References

Please attach actual references

Upload Reference From Fellow *

Click or drag a file to this area to upload.

Upload Reference From Employer *

Click or drag a file to this area to upload.

Declaration

Declaration *

I hereby declare that the information contained in this application is correct, to the best of my knowledge. Further I agree to all provisions set out in the form.