Individual Member Sign up

Fields marked with * are compulsory

Step 1 of 4: General Information

Member grade you are applying for: * (View Available Grades )
Title: *
Surname/Last Name: *

First Name:

Other Names:

Gender: *
Date of Birth (yyyy-mm-dd):
ID/Passport No: *
Nationality: *
Profession:
Mobile:
Alt. Mobile / Tel:
Email:
Fax No:
Permanent Address & Code:
Town:
Nearest KIM Branch of Service: *

Step 2 of 4: Employment Details

Job Title: *
Company Name: *
Date Of Employment
Physical address: (Building, Floor and Street) *
Sector: *
Postal Address:
Code:
Town/City:
Telephone: *
Email: *
Fax:
EMPLOYMENT HISTORY: *
Indicate your employment history
Company Name
Job Title
Years(From - To)
-
-
-

Step 3 of 4: Academic and Professional Qualifications

Upload a detailed current CV and fill the forms below: *

Academic Qualifications: *
Indicate your highest academic qualification (Degree/MBA/EMBA/PHD/Other)
Name of InstitutionCertificate/
Degree attained
Date of completion

Continuous Professional Development courses attended: *
Name of InstitutionCourse attendedExpected
CPD
Points
DurationYearCertified
Certificates

Area of expertise: *
Give the area of expertise that you would like to be trained by KIM
Area of specialization/Expertise: *
Describe your area of experstise:

Professional Qualifications (CPA, CPS, CIB, DIPLOMAS, etc):
Name of institution/
examining body
Qualification attachedDate of completion

Qualification currently studying for:
QualificationInstitutionDate of completion

Personal Interests:


Referees:
NamesAddressTelephonePositionCompany Name

Step 4 of 4: Declaration

I declare that the information given herein is correct to the best of my knowldge and belief, and , if selected, agree to be bound by the Memorandum and Articles of Association and the rules and regulations of the Kenya Institute of Management as they now exist and as may herafter be altered: