Corporate Membership Form

Note: To apply for NiMRA membership, please complete and submit this form. All submissions are subject to Board approval

Membership Type*

Type of Corporate Membership requested

BUSINESS INFORMATION

Business Name*

Office Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Nature Of Business*

Head Office Location(City/Country)*

Telephone 1*

Telephone 2*

Office Email*

Website

Business Registration [CAC] Number*

Year Established*

Number of Employees*

Expectations from NiMRA*

Other Professional Memberships

List other professional associations you belong to

Representative’s Name*

Title First Last

Designation*

Contact Address*

Same as previous

Street Address City State / Province / Region ZIP / Postal Code Country

Direct Phone*

Direct Email*

Applicant*

I agree to abide by the self-regulatory rules of the Nigerian Marketing Research Association as spelled out in the so adapted ICC Code of Ethics and Guidelines.