8/3/2019 CMI GMS Student Registration Form

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Chartered Management InstituteGuaranteed Membership Scheme

1. Name of your place of study:

2. Name of programme:

3. Full time? Part time?

4. Programme start date:

5. Programme end date:

6. Title (Mr, Mrs, Ms, Other):

7. Surname:

8. Forenames:

9. Date of Birth: (dd/mm/yy)

11. Term-time Address:

Postcode:

Country:

12. Mobile tel no:

13. Your personal email*:

*so that we can contact you after graduation to offer you an upgrade to fullmembership.

14. Permanent Home Address:

Postcode:

Country:

15. Home tel no:

16. Ethnicity*:

*Please refer to the Classification codes overleaf

17. Do you consider yourself to be disabled?

Yes No

10. Male Female

For Part Time studying members only

18. Job Title:

19. Name and address of employer organisation:

Postcode:

Country:

20. Work Email:

21. Work Tel:

Before submitting, please refer to the Classification Codes overleaf andcomplete as follows:

Industry sector: Your position:

Organisation type: Your job function:

No. of employees:

22. Is your Business School funding your studying membership?

Yes No

If No, Payment detailsYour membership subscription offers you a year’s studying membership.Benefits can be found on our website.

Studying Membership fee £55

I wish to receive Management Today (UK only) £21BFPO and Republic of Ireland are treated as UKN.B. Please see www.managers.org.uk for the most up to date fees.

a) I enclose a cheque for £ made payable to the

Chartered Management Institute   OR b) Please charge my MasterCard/Visa for £

Card No:

Expiry date: (mm/yy)

Cardholder’s name:

23. Signature:

Date:

Joining the Institute as a studying member on a Guaranteed Membership Scheme  means that you canaccess the benefits of membership immediately. Studying membership is right for you if you are studying, fullor part time, towards a qualification in management or business. Membership of the leading body forprofessional managers brings with it a wide range of benefits and support services. These are designed to aidyour development as a manager at every stage of your career.

To discover the benefits of membership, visit our website at: www.managers.org.uk/benefits 

Please complete each question using block capitals and black ink.

y

g

p

p

Please return this form to:Membership Operations, Chartered Management Institute, ManagementHouse, Cottingham Rd, Corby, Northants, NN17 1TT, United Kingdom.

If you require any assistance in completing this form, please call Membershipon +44 (0)1536 207307. You can access our website atwww.managers.org.uk.

If you have been convicted of a criminal offence, or have a prosecution pending, this must be declared. Adeclaration must be made of insolvency or undischarged bankruptcy. Please note: This information will betreated in the strictest confidence and will only be taken into account if relevant. Spent convictions under theRehabilitation of Offenders Act need not be disclosed. 

We look forward to w elcoming you intomembership. Good luck on your course!

8/3/2019 CMI GMS Student Registration Form

http://slidepdf.com/reader/full/cmi-gms-student-registration-form 2/2