Igbo Community Association in the Midlands Application Form
Please endeavour to complete the entire form
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Section A: Your Personal Details
Title
Mr
Mrs
Dr
Chief
Nze
Lolo
Ms
Other
Name
First Name
Last Name
Gender
Male
Female
Other
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Age Range
18-26
27-42
43-58
Over 59
Under 18
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For Eligible Prospective Associate Members Only*
*Associate Members are non-financial members that satisfy the criteria below
Associate Member Eligibility
Under 18 Years
18-24 and in full time education (NUS)
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Mobile Number
-
Area Code
Phone Number
Email
example@example.com
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Section B: Your Igbo Lineage Details
If you are not of Igbo extraction but your Spouse is, please fill in with the lineage details of your Spouse.
State in Nigeria
Local Government Area
Town/Autonomous Community
Village
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Next Steps
According to ICAM's Constitution, all prospective members (Financial & Associate) will have to pay a one off registration fee of £20 upon completion of this form. Financial members are expected to be up to date with their annual dues before December. Associate Members are exempt from paying membership dues. Please pay your registration fee direct to ICAM's Bank Account: Bank: Barclays - Account Name: Igbo Community in the Midlands - Sort Code: 20-07-89 - Account No: 80147443. Thank you.
ICAM Data Protection Statement
We at the Igbo Community Association in the Midlands (ICAM) understand your need to maintain your privacy as a valued member. ICAM is committed to protecting your data privacy. We will use the information you submit to us via this membership application platform only for internal administrative purposes and we will never share your personal information with any individual or third party. Our processes are consistent with our obligations to our membership and your rights under the law.
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