Institute of Islamic Banking and Insurance - Individual Membership: Application Form

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Individual Membership: Application Form

Membership year runs from January to December.


Type of Application	:	New
Category of Member	:	Member Associate Fellow
IIBI Course Registration No. (if applicable)	:
Title: (Mr, Mrs, Ms, Miss, other )	:
Surname / Family Name	:
First Name(s)	:
Date of Birth	:
Gender	:
Address line 1	:
Address line 2	:
Town / City	:
County or State	:
Postcode or Zip Code	:
Country	:
Nationality	:
Telephone (daytime)	:
Mobile	:
Email	:
Employer's Name & Address (if applicable)	:
Job Title (if applicable)	:
Nature of Employer's Business	:
Previous Employement 1 (employer name, job title, date/duration)	:
Previous Employement 2 (employer name, job title, date/duration)	:
Total number of years of experience	:
Number of years of experience in the Islamic finance sector	:
Last Qualification(s) Gained (Academic/Professional)	:
Name of Awarding Body & Address	:
Upload photograph (Passport size - File not larger then 1 MB)	:
Upload Your CV (File size not larger then 250Kb)	:
Accept 'Declaration' (scroll below)	:
Confirm having read 'Data Protection' information. (scroll below)	:

After pressing "Submit" button you will be directed to section to allow you to make payment.

Make payment after pressing 'Submit' button

Individual Membership fee: Payment by credit/debit card

£.25.00

Select

Other Payment Options

By Bank Transfer

Your name should be mentioned on the bank transfer

A/C Holding bank	Lloyds TSB Plc
Name A/C	Institute of Islamic Banking and Insurance
A/C No.	01099227
Sort Code	30-94-81
IBAN	GB10LOYD 3094810 1099227
BIC SWIFT	LOYDGB21024

By Cheque / Bank Draft issued in the name of “ Institute of Islamic Banking and Insurance”. Your fee cheque/bank draft should be mailed to IIBI, quoting "Membership Application" and your name.

Institute of Islamic Banking and Insurance

7 Hamsptead Gate,1A Frognal

London, NW3 6AL

United Kingdom

Declaration

By submitting this form I confirm that I have read the Code of Ethics prescribed by IIBI and will endeavour to abide by it.

I also confirm that the details given in this application form are correct and that I am a fit and proper person to be accepted as a member of IIBI.

I undertake to pay the fee as may be applicable and I understand that the continuation of my membership is conditional upon such payment.

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Data Protection

The information provided will be used by IIBI for administrative and membership purposes or as required by law. IIBI will use your information to keep you informed with news of IIBI activities, overview of important developments and implications for the industry as well as industry debate. By submitting this application form, you will be indicating your consent to receiving such information by email and/or by post.

We do no not sell list of IIBI members or share details with third parties. However, your details will be included in IIBI member’s lists or a IIBI members directory circulated to other members who may contact you. If you do not wish your contact details to be shared with other members, you should advise us in writing by email and/or by post.

Application form PDF version for payment by cheque or by bank draft

Download

Individual Members application form 2012.pdf (34 KB)

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Individual Membership fee: Payment by credit/debit card

£.25.00

Select

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