CiK Governor Group - CiKGG (International)

www.CiKcommunity.net

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Membership Application Form

All information you provide is

confidential and shall not be revealed to a third party without the applicant consent

. The information included in this form is maintained for the Group admin sole purpose and shall be utilized to maintain the best interest of Group members while coordinating future events.

The CiKGG membership year runs from October 1 thru September 30

.

First Name:……………………………………………………

Kuwait contact information (if applicable)

Surname:………………………………..

Membership Category: Single  Family  Nationality :……………………………………………Date of Birth: (Day/Month) ……/…….

Area of residence: Home Tel: Email: Email:

General information

Work: Mobile: Do you work in Kuwait? Yes  No  Profession: __________________________________________ Would you be interested in receiving information on business associations in Kuwait? Yes  No  Would you be interested in acting as a contact / guide for a new arrival to Kuwait? Yes  No  Do you have children in Kuwait? Yes  No  Ages: ________________________________________ Would you be interested in: Family activities? Yes  No  Singles activities? Yes  No  Planning/running activities? Yes  No  Volunteering on the CiKGG future sub Committees? Yes  No  How did you know about the CiKGG? _____________________________________________________ Suggestions for CiKGG activities/events:____________________________________________________

Member agreement

I hereby agree to abide by the official published charter and code of Conduct of the CiKGG and all of its amendments Signature_________________________ Date: _____/ ______/_____

This Section shall be filled in by CIKGG group admin only

Cash received by: _________________________________ Date:______/________/________ (day) (month) (year) Application Approved:: Yes  No  Date:______/_______/_______

Group Director General Signature

:_____________________________________________ CIKGG ID NO. _____________ Delivered to the member on Date: _____________________