Membership Application Form

SECTION A: PERSONAL INFORMATION

Full Name*

First name Surname

Gender*

Date of Birth*

Residential Address*

Street Address City State Country

Nationality*

Phone Number*

WhatsApp Numbeer*

Email Address*

Section B: MEMBERSHIP APPLIED FOR

Select Membership Applied For:*

Fellow

Member

Corporate

SECTION C: EDUCATIONAL BACKGROUND

Highest Qualification*

Institution Attended*

Course of Study*

Year of Graduation*

Additional Professional Qualifications, if any

SECTION D: AGRIBUSINESS AND PROFESSIONAL EXPERIENCE

Current Occupation*

Current Organization or Business Name*

Current Position or Role*

Years of Experience in Agriculture or Agribusiness*

Area of Experience*

Briefly describe your relevant professional or business experience*

SECTION E: PAYMENT INFORMATION

Applicants may pay the required Membership application fee through any of the following options..

OPTION 1: Membership Applicant can pay securely through the official online payment gateway.

Membership Fee
Fellow – 550,000
Member – 350,000
Corporate -650,000

Click Here to pay online.

After completing your online payment, please return to this application form and select the appropriate payment status below.

OPTION 2: Bank Transfer Local candidates may pay directly into the Institute’s Naira bank account.

Fellow – 550,000
Member – 350,000
Corporate -650,000

Bank Name: Zenith Bank
Account Name: Institute of Agribusiness Management
Account Number: 1014643766

After payment, please return to this application form and select “I have paid by bank transfer” under Payment Status.

Please select your payment status*

I have paid online

I have paid by bank transfer

Name of Applicant or Payer:

Amount Paid

Date of Payment

SECTION F: SUPPORTING DOCUMENTS UPLOAD

Please upload all required documents in this section.

Required uploads: Passport photograph, valid means of identification, academic certificate or statement of result, and evidence of payment. Optional upload: CV or brief professional profile, especially for applicants applying based on work or business experience.

Upload Passport Photograph*