gabm membership application form

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MEMBERSHIP MEMBERSHIP MEMBERSHIP MEMBERSHIP APAPAPAPPPPPLICATION FORMLICATION FORMLICATION FORMLICATION FORM


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Website: www.gabm-pinc.com E-mail: [email protected]

Global Association of Billionaires and Millionaires (GABM) is an unincorporated association of members regulated by its own Constitution. This is an application to apply for GABM associate membership, subject to the conditions contained in its Constitution.

To apply for individual associate membership, complete sections A, C and E below. To apply for corporate associate membership, complete sections B, C and E below.

Section A – Individual Application

Surname: First Name: Full Names: Postal Address and Code: Physical Address: Telephone (Home): Telephone (Work): Mobile Number: Fax Number: E-mail Address: Social Security or Personal Identity Number: Passport Number: Expiry Date of Passport: Date of Birth: Occupation: Specialist Field: Qualifications:


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Employer: Position: Membership of other professional organizations:

Section B – Corporate Application Registered Name of Organization: Trade Name: Type of Organization: Registration Number: Date of Incorporation: Postal Address and Code: Registered Address and Code: Number of Members or Partners: Designated Representative: Telephone Number: Fax Number: E-mail Address: Website Address: Nature of Business: Membership of other professional organizations:


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Section C – Associate Membership Categories

GABM makes provision for three categories of associate membership. Kindly, indicate below your application preference:

1. Platinum Associate Membership Status

Platinum Associate Membership Status can only be allocated to a business executive or entrepreneur, a company, trust or partnership whose net asset value exceeds one billion in the currency unit of the applicant’s country of residence or incorporation or any such amount as management of GABM may from time to time determine. Associate membership fees are not refundable under any condition or for whatsoever reason.

Platinum Associate Membership can be obtained for an annual amount of $20 000 US Dollar, or any such amount as management of GABM may from time to time determine. I/we herewith apply for Platinum Associate Membership Status …………

2. Gold Associate Membership Status

Gold Associate Membership Status can only be allocated to a business executive or entrepreneur, a company, trust or partnership whose net asset value exceeds one million in the currency unit of the applicant’s country of residence or incorporation or any such amount as management of GABM may from time to time determine. Associate membership fees are not refundable under any condition or for whatsoever reason.

Gold Associate Membership can be obtained for an annual amount of $10 000 US Dollar, or any such amount as management of GABM may from time to time determine. I/we herewith apply for Gold Associate Membership Status …………….

3. Silver Associate Membership Status

There are no fees applicable to Silver Associate Membership, as this category of associate membership is only allocated to honorary associate members, Regional Chamber Chairman and GABM Goodwill Ambassadors on the sole discretion of GABM’s Board of Executives. I/we herewith apply for Silver Associate Membership Status …………….

NB: If you are applying for a Regional Chamber Chairman or GABM Goodwill Ambassador Position, kindly indicate your country of residence as well as for which position you (or the company) are applying for:

Your country of residence: _________________________________________________________

I am applying for the following position (Indicate preference below):

• Regional GABM Chamber Chairman ………………..

• GABM Goodwill Ambassador............………………..

YES NO

YES NO

YES NO


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Section D – Payment Payment of your first annual Associate Membership fee will only be accepted by direct transfer into GABM’s authorized Management Firm’s account. Section E – General • I hereby confirm that the above information is true and complete, and I give approval that any

information may be fully investigated. I further give my consent to such source to provide confidential information.

• I hereby confirm that I am familiar with the general information pertaining to GABM, as contained in its website.

• I hereby confirm that I have read the Constitution of GABM, and confirm that I fully understand and unconditionally agree and accept to the conditions contained therein.

• I hereby confirm that I have been made aware of my membership conditions and I certify that I fully comply with GABM’s Membership Qualification Criteria, as set forth in the Constitution of GABM.

• I am willing and prepared to provide documented prove, if and when requested by the Board of Executives of GABM, to substantiate and certify to my compliance to such membership qualification criteria.

• I hereby confirm that I was not solicited, influenced, or unduly persuaded to become an associate member of GABM. My application to become an associate member is solely motivated by my own convictions.

• I attach herewith my comprehensive, detailed Curriculum Vitae (if applicant is an individual) or a detailed Company Profile (if applicant is a company) as well as a copy of my passport or an identity document.

• I hereby give my full and unconditional consent in terms of which GABM is allowed to forward to me any marketing or promotional material from its valued Advertising Clients.

Kindly complete the section below in detail: NB: This application will only be processed if fully completed and received by GABM NB: Kindly forward your completed and scanned Membership Application Form to the Board of Executives of GABM at: [email protected] GABM Proposer - Name: _________________________________________________________ GABM Proposer - Associate Membership Number: ______________________________________ (If Applicable)

GABM Proposer - Country/State: ____________________________________________________ Applicant Signature: ____________________ __ Date: _______________________________

gabm membership application form

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