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Membership/ Renewal Form: Indian Association of Permanent Makeup

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Membership/ Renewal form

Indian Association of Permanent MakeUp

Purpose:

NEW MEMBERSHIP RENEWAL CHANGES FOR DIRECTORY

SECTION 1: MEMBER CONTACT INFORMATION

TITLE Mr Mrs Miss Ms Dr

NAME

ADDRESS

Country

PIN /ZIP code

Mobile number

Email address

Birthdate
DDMMYYY

SECTION 2: MEMBERSHIP TYPE


MEMBERSHIP Please
Membership type
DUES (INR) Check

1 Life membership 12000

2 Provisional membership 5000

3 Associate Membership 5000

4 Annual Membership 1500

For Membership descriptions see website www.iapmu.org

Institutional Cheque Personal Cheque Online Payment


PAYMENT
METHOD For Bank account details please check www.iapmu.org

*Please note that all memberships will be subject to approval by the membership committee of IAPMU

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SECTION 3: ADDITIONAL INFORMATION
Current Occupation/ job title

Highest / latest qualification

Are you a member of any other professional association? If so, please mention names and website
address of the association

Describe in short your association with Permanent makeup and your reason for being a member of
IAPMU

Are you associated with any PMU training institute as a faculty or admin? If yes, please give details

Photographs and videos of IAPMU members may be used in various IAPMU communications incl.
the newsletter and website. Group photographs & videos taken at IAPMU events may be used
without identifying individual members. By signing below, you are indicating your permission for use
of such photos & videos.

I, the undersigned, declare the above information on page 1 & 2 true to the best of my knowledge.

Along with this, I am attaching (please check

o Govt issues photo ID


o Address proof
o Qualification certificates
o Experience certificates
o Proof of eligibility depending on the type of membership

Name, signature and date


Kindly send a duly signed copy of this form to the IAPMU address mentioned on www.iapmu.org along with all relevant documents and
cheque in the name of “Indian Association of Permanent Makeup”, f payment is by cheque. Cheque will be deposited in the bank only after
membership is approved. If payment is by online transfer, your membership approval email will contain instructions for online payment.

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