Individual Membership Form

Corporate Membership is renewable on an annual basis and nominated representatives can be changed at any time.

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Username: This is a valid username This username is already used.

Password:

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First Name:

Middle Name:

Last Name:

Nickname:

Position:

Division / Dept. :

Company Name :

Business Address :

Phone :

Fax :

Email :

Company Main Line of Business

Date of Birth:

Place of Birth:

Citizenship:

Civil Status:

Home Address:

City:

Province:

Home Telephone:

EDUCATION

High School:

College/University:

Year Completed:

Degree:

Post-Graduate:

Papers Published:

PROFESSIONAL/CIVIL AFFILIATIONS

Organiztions:

Have you been a member of the PMA? Yes No

if yes, when?

EMPLOYMENT HISTORY

Current Employer:

Position:

Employment Date:

Brief Description:

Attach a bio-data with photo, for additional employment Information

MARKETING AREAS OF INTEREST

You may select more than one

PMA COMMITTEE PARTICIPATION

You preferred committee memberships - choose at least 2

Complete & submit this application form to the

Philippine Marketing Association

Email: [email protected]

Fax: 634-4890

Mail: Suite 1006-A, West Tower, Phil. Stock Exchange,

Exchange Rd., Ortigas Center, Pasig City

For inquiries, pls call: 634-5722; 634-56647

Websote: www.philippinemarketing.net.ph

For office use only: PMA MEMBERSHIP COMMITTEE

PMA Secretariat:

Chairman:

VP-Membership:

President:

Date: