Gabm Membership Application Form

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  • 1. MEMBERSHIP APPLICATION FORM APP© Copyright. Global Association of Billionaires and Millionaires. All rights reserved. 1
  • 2. Website: www.gabm-pinc.com E-mail: info@gabm-pinc.comGlobal Association of Billionaires and Millionaires (GABM) is an unincorporated association ofmembers regulated by its own Constitution. This is an application to apply for GABM associatemembership, 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 ApplicationSurname: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: © Copyright. Global Association of Billionaires and Millionaires. All rights reserved. 2
  • 3. Employer:Position:Membership of other professional organizations:Section B – Corporate ApplicationRegistered 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: © Copyright. Global Association of Billionaires and Millionaires. All rights reserved. 3
  • 4. Section C – Associate Membership CategoriesGABM makes provision for three categories of associate membership. Kindly, indicate below yourapplication preference:1. Platinum Associate Membership StatusPlatinum Associate Membership Status can only be allocated to a business executive orentrepreneur, a company, trust or partnership whose net asset value exceeds one billion in thecurrency unit of the applicant’s country of residence or incorporation or any such amount asmanagement of GABM may from time to time determine. Associate membership fees are notrefundable under any condition or for whatsoever reason.Platinum Associate Membership can be obtained for an annual amount of $20 000 US Dollar, orany such amount as management of GABM may from time to time determine.I/we herewith apply for Platinum Associate Membership Status ………… YES NO2. Gold Associate Membership StatusGold 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 ofthe applicant’s country of residence or incorporation or any such amount as management of GABMmay from time to time determine. Associate membership fees are not refundable under anycondition or for whatsoever reason.Gold Associate Membership can be obtained for an annual amount of $10 000 US Dollar, or anysuch amount as management of GABM may from time to time determine.I/we herewith apply for Gold Associate Membership Status ……………. YES NO3. Silver Associate Membership StatusThere are no fees applicable to Silver Associate Membership, as this category of associatemembership is only allocated to honorary associate members, Regional Chamber Chairman andGABM Goodwill Ambassadors on the sole discretion of GABM’s Board of Executives.I/we herewith apply for Silver Associate Membership Status ……………. YES NONB: If you are applying for a Regional Chamber Chairman or GABM Goodwill AmbassadorPosition, kindly indicate your country of residence as well as for which position you (or thecompany) are applying for:Your country of residence: _________________________________________________________I am applying for the following position (Indicate preference below):• Regional GABM Chamber Chairman ………………..• GABM Goodwill Ambassador............……………….. © Copyright. Global Association of Billionaires and Millionaires. All rights reserved. 4
  • 5. Section D – PaymentPayment of your first annual Associate Membership fee will only be accepted by direct transfer intoGABM’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 GABMNB: Kindly forward your completed and scanned Membership Application Form to the Board ofExecutives of GABM at: info@gabm-pinc.comGABM Proposer - Name: _________________________________________________________GABM Proposer - Associate Membership Number: ______________________________________ (If Applicable)GABM Proposer - Country/State: ____________________________________________________Applicant Signature: ____________________ __ Date: _______________________________ © Copyright. Global Association of Billionaires and Millionaires. All rights reserved. 5