IPPM

Institute of Public Peace and Management

(With approval of the Federal Ministry of Justice and the Ministry of Education)

Membership Application Form

📸 Passport Photo

📷 Upload or capture

💰 Application Fee: ₦10,000 Pay into: IPPM GTCO PLC 0210498847

Upload Bank Payment Receipt * (Attach a clear image or PDF of your payment)

Section 1. General Information

Surname *

First Name *

Other Names

Title (Mr, Mrs, Miss, Dr, etc.)

Date of Birth *

Nationality *

Company Name & Address

Address for Correspondence *

Telephone Number(s) *

E‑mail Address *

Job Title

Section 2. Academic & Professional Qualifications

In support of your application please submit a copy of your CV, academic and professional certificates. Electronic copies or camera shots are acceptable. DO NOT ENCLOSE ORIGINAL DOCUMENTS.

Academic Qualifications (Start with the highest)

Name of Institute	Certificate / Degree (with discipline)	Year

Professional Qualifications (e.g. ACA, ACIB, ACIL, AIIM, AIPM, etc.)

Institute / Examining Body	Qualification obtained	Year

Curriculum Vitae (CV)

Academic / Professional Certificates

Payment Receipt (If not uploaded above)

Section 3. Employment History

List the TWO most recent positions, starting with the current one.

1. Organisation name

Position held

Date (from‑to)

Main responsibilities

2. Organisation name

Position held

Date (from‑to)

Main responsibilities

Section 4. Membership Categories

Please select the appropriate category:

Nysc‑Associate‑AIPM

Associate‑AIPM

Full Members‑FMIPM

Senior Members‑SMIPM

Fellow‑FIPM

Distinguished Fellow‑DFIPM

Honorary Fellow‑HFIPM

Plenipotentiary Fellow‑PIPM

* Upgrades in membership are possible with further training and demonstrated readiness.

Section 5. Referee

Name of Referee

Address (including telephone & e‑mail)

Section 6. Declaration & Certification

I declare that the information given is correct to the best of my knowledge. I agree to support the mission of the institute, commit to high ethical standards, and be bound by the rules and regulations of the Institute of Public Peace and Management (IPPM).

Applicant's Signature and Date *

Section 7. For Official Use Only

Date Received (DD/MM/YYYY)

Registration Number

Payment Receipt No.

Name & Signature of Officer

Official Remarks