ICMM Affiliate Membership Application form

ICMM Affiliate Membership Application form

For Non-Governmental Organisations, research institutes, governmental organisations, private companies and emerging organisations involved in maritime heritage.
Name of your organisation in English:*
Name of your organisation in original language:
Please give a brief description of the business of your organisation:*
100 words max
Please give the reason your organisation would like to join ICMM:*
100 words max

Contact Details
Name of your Director:*

First NameLast Name
Director's job title:*
Director's email address:*
example@example.com
YesNo
Name of primary contact at your organisation (if not the Director):

First NameLast Name
Primary contact's job title:
Primary contact's email address:
example@example.com
YesNo
Email address of finance contact: (Please ensure this contact can receive and process your ICMM membership annual invoice)
example@example.com
Postal address of your organisation:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website address of your organisation:*
General contact email for your organisation:*
example@example.com
Twitter account of your organisation (so we can follow you for news):
Facebook page of your organisation (so we can follow you for news):
LinkedIn page of your organisation (so we can follow you for news):
Should be Empty:

Contact Details