"The Institute of Sales & Marketing Management"

Individual Membership Fees

Annual subscription – £98.00 by Direct Debit, £108.00 by credit card
£23.50 registration fee waived for online application
Make your payment by any of the following methods. Please complete the appropriate section.

Individual Membership Application Form

PERSONAL DETAILS:

Title:
Forename(s):
Surname:
Date of Birth:
Job Title:
Home Address:

Postcode:
Home Telephone Number:
Work Telephone Number:
Mobile Number:
Email:

EMPLOYMENT DETAILS:

Current employer’s name and address:



Job title and duties:


Telephone Number:
Email Address:
Nature of business:
Approx size of salesforce?
How long in current position?

(1) Previous employer’s name and address:



Previous Job title:
	Employed from: to:
Total period employed in sales/marketing:

(2) Previous employer’s name and address:



Previous Job title:
	Employed from: to:
Total period employed in sales/marketing:

REFERENCES:

Details of Senior executive at your present place of employment to whom we may apply for a reference. If you are self-employed, give details of your accountant or other professional who can provide a business reference.
Name of referee:
Job Title:
Company name & address:


Postcode:
Telephone Number:
Fax Number:

How did you hear about the ISMM?

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