Individual Member – Application Form – African Association of Compliance Professionals in Financial Services (AACPFS)

Personal Information

Username*

First Name*

Last Name*

Other Names

Password*

Confirm Password*

E-mail Address (Gmail or Yahoo mail)*

Birth Date*

Gender*

MaleFemale

Country of Residence*

Have you been convicted of a criminal offence, been subject to disciplinary action by a statutory professional or other body, or are you currently subject to a notice not to practice within the Financial Designated / Non Financial Institutions?*

YesNo

Recent Passport Photograph*

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Contact Information

Mobile Phone Number*

Residential Address

Official Address*

Alternative Mobile Number

Alternative E-mail Address

Preferred method of contact

EmailTelephone

Employment/Business Details

Organisation*

Private SectorPublic Sector

Industry*

Please specify your industry*

Company Name*

Company Address*

Job Title*

Job Description*

Company Email*

Company Telephone*

Membership Eligibility Criteria

Each applicant must meet at least 2 of the following criteria (please tick as appropriate)*

Qualifications

Acknowledgment and Consent

I authorize the Institute to list my name on the appropriate Register of Membership. I agree to be bound by the regulations of the Institute if my application is successful.

Only fill in if you are not human

Individual Member – Application Form

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