CBM Membership Application Form
PERSONAL DATA
Mr./Ms./Mrs./Miss/Dr. *
Surname *
First Name *
Middle Name *
Suffix
Date of Birth: *
Gender * MaleFemalePrefer not to say
CONTACT INFORMATION
HOME MAILING ADDRESS
Home / Bldg. No.*
Bldg. Name / Street / Road / Subdivision*
Barangay*
City *
Province / Region *
Postal Code *
Phone Number *
Mobile Number *
Personal E-mail Address *
BUSINESS MAILING ADDRESS
Position
Company Name
Unit / Bldg. No.
Bldg. Name / Street / Road / Subdivision
Barangay
City
Province
Postal Code
Phone Number
Fax Number
E-mail Address
EDUCATION & PROFESSIONAL INFORMATION
BACHELOR’S DEGREE
Course
University
Year
MASTERAL
DOCTORAL
OTHER
FEES
CBM Certification Package
Php 7,800
PROOF OF PAYMENT
Make sure to upload *Scanned Copy or Screenshot of your VALIDATED Proof of Payment with transaction details such as Date of Transaction, Payment Reference no., Amount Paid, Bank Account no. (should be visible)
*Upload your file here (File name must be: Surname_FirstName):
DATA PRIVACY
Upon signing this form you are agreeing that the personal data obtained from the registration form entered and stored within the Institute’s authorized information and communications system and will only be accessed by the SMI authorized personnel. Furthermore, the information collected and stored in this form shall only be used for the following purposes:
Announcements / promotions of events, programs, courses and other activitiesoffered / organized by the Institute and its partners;
Activities pertaining to establishing relations with participants/members/alumni;
SMI Philippines has the right to share your information to our related affiliate companies, institutions, and or subsidiaries;
SMI Philippines shall not disclose the participants/members/alumni personal information without their consent and shall retain this information over a period of ten years for effective implementation, research analytics, and management.
ACCEPTANCE OF SUBSCRIPTION
I declare that all of the information contained in this application is true and correct and I agree to provide any supporting documentation requested by the Institute. If accepted, I agree to abide by the Sales and Marketing Institute International Philippines' Code of Professional Conduct and Continuing Professional Education requirements. I understand that I must renew my subscription annually to enjoy the services provided by the Institute including eligibility privileges and retention of professional designation.
Yes, I accept
Digital Signature *
Date Signed *
Please double check your PERSONAL EMAIL if entered correctly before submitting the form. Confirmation email will be sent there.
