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REGISTER

Instructions: carefully read through the form before filling. Only duly completed forms with attached CVs and passport photographs will be processed.
TITLE (Prof./ Dr./ Mrs./ Miss): DATE (DD/MM/YYYY):
NAME (SURNAME FIRST): DOB (DD/MM/YYYY):
RESIDENTIAL ADDRESS: OFFICE ADDRESS:
MOBILE NO: OFFICE PHONE NO:
Email (personal): Email (Official):
WEBSITE: PLEASE UPLOAD YOUR CV:

HIGHEST EDUCATIONAL LEVEL ATTAINED (Please tick as Appropriate):
'O' Levels OND HND BACHELOR'S DEGREE Masters PhD

PROFESSIONAL QUALIFICATIONS AND AFFILIATIONS (PLEASE LIST):
1.
2.
3.
JOB TITLE (S):

WORK EXPERIENCE (in Yrs.):
0-3 4-7 8-11 12-15 16-19 20 and above

Have you attended any WIMBIZ event? (Kindly tick as appropriate):
1. Roundtable lunch 1-3 times 4-6 times 7-9 times 10 + times
2. Annual Conference 1-3 times 4-6 times 7-9 times 10 + times
3. Market Place 1-3 times 4-6 times 7-9 times 10 + times
4. Annual Lecture series 1-3 times 4-6 times 7-9 times 10 + times

Are you a WIMBIZ mentee? Yes No
In a few words, kindly state the reason(s) for your interest in being a member of WIMBIZ:
Declaration
I hereby declare that the information given herein is, to the best of my
knowledge and belief, correct.
Signature Date
Reference I
I of Mobile phone No: Email:
hereby affirm that I know the applicant and can stand as a surety for the applicant in all matters relating to WIMBIZ.
Signature Date:
Reference II
I of Mobile phone No: Email:
hereby affirm that I know the applicant and can stand as a surety for the applicant in all matters relating to WIMBIZ.
Signature Date:

Note:
  • Read the Terms and conditions of the WIMBIZ membership platform at www.wimbiz.org.
  • Application form to be filled in Triplicate
  • Each Application will be considered on its own merit.
  • Changes in any of the information supplied in this Application Form should be communicated to the secretariat.

Please send a completed copy of this form, your recent passport photograph (hard copy or JPEG file format) and a 2-page CV to
WIMBIZ Secretariat, 200B Isale Eko Avenue, Dolphin Estate, Ikoyi, Lagos
Or email to wimbiz@wimbiz.org or wimbizng@gmail.com.
For Enquiries, please call 0803 594 6249
Visit our website at www.wimbiz.org

The Executive Secretary,
Women in Management and Business,
200b Isale Eko Avenue, Dolphin Estate
Lagos.
Tel./Fax: 01-271-2521; 0803-594-6249; 0803-494-6249
WIMBIZ Vision: "To be the catalyst that elevates the profile and influence of women in management and business"
FOR OFFICIAL USE ONLY
WIMBIZ Associates Information Sheet
i. Criteria for membership:
  1. Minimum educational qualification: OND;
  2. Minimum post-qualification experience (Corporate or business):
    • OND Holder: 5 years;
    • HND and above: 3 years;
  3. Where the above does not apply, 10 years' experience as an entrepreneur;
ii. References:
  1. Two Referees to sign the Application Form;
  2. 2. Categories of persons to be Referees:
    • WIMBIZ Trustee
    • Applicant's employer, Reputable Professional or Business Associate.
iii Documents to accompany Application Form:
  1. Two recent passport photos taken against white background with Applicant's full names and signature at the back;
  2. Two-Page Curriculum Vitae.
IV. Benefits of Associate Membership:
Kindly find the benefits of being an associate member
  1. Networking opportunities;
  2. Discounts at WIMBIZ events;
  3. Attendance at Associates-only events;
  4. WIMBIZ Travel, Book and Spa Clubs
  5. Access to Password-dedicated part of Website;
  6. Discounts/Special Offers from participating companies and lots more
V. Payments
Payments to be made on admission to Associate membership shall be by Bank Draft for N75, 000.00 made payable in Lagos to 'Women in Management & Business'
  1. Registration Fee and cost of Induction Pack: N50,000.00;
  2. Annual dues: N25,000.00
  3. A fee of N25,000 will be paid the second year after induction
IMPORTANT: Kindly note that payment should not be made until you have been contacted as selected for Membership.