CIPM - Training Request Form

PLEASE FILL THE FORM AND SUBMIT

Title of Programme

Date of Programme

Venue

Name of Organisation

Address of Corp./Ind. Street:

City

State

Country

Tel:

email

Fax

Nominees

Nominating officer:

Designation:

Amount Paid

All monies payable in the Institute’s favour can be made at any branch of United Bank for Africa (UBA) Plc on A/c. No. 2182010000887 or Intercontinental Bank Plc A/c. No. 0004-001-000005078. The deposit tellers must be forwarded to the National Secretariat with the name, payment purpose, membership grade and branch (for members only) clearly indicated overleaf.