Institute of Place Management                     
Application for Election to Membership: Affiliate
BEFORE YOU BEGIN!

Before proceeding with online submission please be aware that you must complete the application form in its entirety before submitting (approximately 15 minutes) – there is no option available to save form content at any time.

Please note that when you have completed your application form online you must proceed to online payments (below) in order to submit your application – you will not be able to submit your online form without this initial assessment fee payment.

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1. APPLICANT’S INFORMATION (help?)

Please provide us with your Surname and the title and forenames that you prefer to known by. Please note the address to which all hard copy correspondence should be sent and provide an up-to-date email address, as we will need this for most of our communications with you.

Required fields with (*) must be filled in.
Name*: Surname*:
DOB: Email*:
Address: Postcode:
Country: Contact Number :
 

2. EDUCATION (help?)

Please give full details of your degree level or higher qualifications. For degrees please state the name of the degree and the class awarded as well as the start and completion dates and whether you studied full of part-time. Finally, please identify at what level the degree is (degree or higher degree).

For degree-level equivalent qualifications (for example NVQs) please describe the name of the award, the awarding body, the start and completion dates and whether you studied full or part time. Please also state the institution that offered the award.

Please also list all other degree-level or higher qualifications in this section (e.g. the Introductory Diploma in Place Management or Diploma in Management Studies). Please note, this section is for degree-level (or higher) qualifications only, there is no need to include GCSE or ‘A’ level qualifications or their equivalents.
Degree/Class/Title: Start Date: (Month/Year) Completion Date: (Month/Year) Postgraduate/ Undergraduate Full-time/ Part-time
Degree/Class/Title: Start Date: (Month/Year) Completion Date: (Month/Year) Postgraduate/ Undergraduate Full-time/ Part-time
Degree/Class/Title: Start Date: (Month/Year) Completion Date: (Month/Year) Postgraduate/ Undergraduate Full-time/ Part-time

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Degree/Class/Title: Start Date: (Month/Year) Completion Date: (Month/Year) Postgraduate/ Undergraduate Full-time/ Part-time
Degree/Class/Title: Start Date: (Month/Year) Completion Date: (Month/Year) Postgraduate/ Undergraduate Full-time/ Part-time
Degree/Class/Title: Start Date: (Month/Year) Completion Date: (Month/Year) Postgraduate/ Undergraduate Full-time/ Part-time

3. CURRENT MEMBERSHIP OF OTHER PROFESSIONAL INSTITUTIONS (help?)

Please indicate the name of the professional institute(s), your level of membership and the date of election.
Institution Name   level of Membership   Date of Election
 
Institution Name level of Membership   Date of Election
 
Institution Name level of Membership   Date of Election
 
 

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Institution Name   Level of Membership   Date of Election
 
Institution Name Level of Membership   Date of Election
 
Institution Name Level of Membership   Date of Election
 
 

4. CURRENT JOB DESCRIPTION (help?)

Please paste your current job description into your application or alternatively enter your current duties and responsibilities. If you do not have a job description please list your responsibilities and duties as fully as possible.
 

5. EQUAL OPPORTUNITIES MONITORING (help?)

The information requested is for monitoring purposes only.

Please tick the box that best describes your Ethnic Origin:
White Mixed (white & black Caribbean) Black - Caribbean
Indian Mixed (white & black African) Black - African
Black - other Mixed (white & Asian) Mixed (other)
Pakistani Bangladeshi African
Chinese Other Prefer not to say
 
Nationality: What Nationality are you?
 
Sex:    Male     Female
 
Disability: Do you suffer from any disability? Yes No Prefer not to say
 

6. APPLICANT’S DECLARATION (help?)

Please read the statement and make sure the information contained within your application is accurate. By ticking the statement box you agree to comply with the Institute’s Code of Conduct and pay your annual membership fee upon acceptance into the Institute.

Required box with (*) must be ticked.
You wish to be elected as a Member of the Institute of Place Management and will take an oath to abide by the Institute’s Code of Conduct.  Upon acceptance into the Institute, I understand that I am liable for membership fees and will pay the appropriate fee upon request. The information I have given in this form is a full and accurate description and I consent to any of the individuals or institutions detailed in this form being contacted for the purposes of corroboration.
By ticking this box you aggree to the terms and conditions
IMPORTANT: If, after submitting (below), nothing happens after 10 seconds please review your application for incomplete fields - highlighted in red