MENU
Home
Who we are
Membership
Major Corporate
Corporate
Small and Medium Enterprises
Individual
Student
Honorary and Fellows
Community
We are a member of
We are a strategic partner with
Archives
Governance Codes
Legislation
Thought Leadership
Governance Toolkit
Webinars and Trainings
Conferences
Videos
Gallery
Contact Us
FAQ
Individual
Membership Application
A) ORGANISATION
Name
Registration No:
Date of Registration
Business Address
Postal Address
Town/City
Region
Country
Statute under which the company / organisation is registered (e.g. Companies Act 2004)
Main Objectives / Principal Activities
Section of Economy operating in
B) KEY CONTACT ON MEMBERSHIP MATTERS
(This section must be completed)
Name of Representative
Email
Designation
Department
Direct Tel No.
Direct Fax No.
Mobile No.
Name of Representative (Alternative)
Email
Designation
Department
Direct Tel No.
Direct Fax No.
Mobile No.
C) KEY CONTACT ON EVENTS
(This section must be completed)
Name of Representative
Email
Designation
Department
Direct Tel No.
Direct Fax No.
Mobile No.
D) PAYMENT METHOD
For EFT or direct payment, please email copy of transaction slip to info@nicg.org.na
BANKING DETAILS
Name of Bank
: First National Bank Namibia
Account Number
: 62275853507
Branch Code
: 281872
Branch
: FNB Commercial Branch
E) I DECLARE THAT:
All information contained in this application form is true and correct.
This is an application for membership. No reference of affiliation with NICG (Namibia) will be made until approved and accepted.
If accepted, I agree to abide by the Memorandum and Articles of Association and Rules / Codes of the Namibia Institute of Corporate Governance (NICG).
SEND