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670 Lafayette Ave, Brooklyn,
NY 11216

+1 800 966 4564
+1 800 9667 4558

Membership Application

Attach passport photo for your Membership Identification Card

Attach Photo*
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Attach passport photo for your Membership Identification Card
Category of Membership Applied for*
Full Name*
First Name Last Name
Title/Position*
Gender*
Age*
Nationality*
Local Government Council*
Business Name
Address*
Professional/Academic Qualifications*
Are you a member of any professional/trade association?*
If Yes, Name/s
Type of Business/Product or Service Line*
Office Telephone/Fax*
Email*
Website
Home Telephone
How did you hear about CICMSP?*
Would you like to serve in any ICMSP Committee?*
If Yes, Choose One
CICMSP Will Notify Members Of Their Chosen Committee
- ASSOCIATE – ₦75,000
- FULL MEMBER – ₦90,000
- FELLOW – 150, 000
- CORPORATE – ₦500,000
- (ASSOCIATE MEMBER: FOR NYSC MEMBERS ONLY) – ₦45,000
Corporate and individual membership fees are payable in full on Application for membership. Photocopies of available credentials must follow application for membership decision purposes. The decision of the Membership Committee is final.
Amount Paid*

Payments must be made into any branch of ZENITH BANK PLC. Nationwide, Account No. 1017219869. All payment slips should be forwarded to the institute.
Full Name*
Date*