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ICMA Membership Application Form
1
SECTION ONE
2
SECTION 2
We herewith apply for
(Required)
First year Standard membership
Open to companies operating in a single country or territory
(Only available to companies who have not been ICMA members during the 18 months directly preceding their application.)
12 month fee for the first year of membership – € 1195
First year Group membership
Open to companies with operations in more than one country or territory.
(Only available to companies who have not been ICMA members during the 18 months directly preceding their application.)
12 month fee for the first year of membership – € 2495
Name of Company
Address
Street Address
Address Line 2
City
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Phone
Value Added Tax (VAT) number
For EU countries only
Parent Company (if applicable)
Website URL(s)
CEO/MD
Email address
Number of employees (Full-time)
Number of employees (Part-time)
Countries operated in
Annual turnover (€ equivalent)
Number and business model of classified products
Fill in as many as apply
Mobile sites
Social sites
Niche online sites
Free ads papers
Paid ads
Niche papers
Online sites
Others
Contact details of other key employees
CONTACT DETAILS OF OTHER KEY EMPLOYEES THAT YOU WISH TO BE ADDED TO THE ICMA DATABASE (USED FOR MAILING THE NEWSLETTER, CONFERENCE PROGRAMMES AND INFORMATION UPDATES; DATA IS NEVER MADE AVAILABLE TO THIRD PARTIES). N.B. APPLICANTS FOR GROUP MEMBERSHIP ARE REQUESTED TO PROVIDE CONTACT DETAILS FOR AT LEAST ONE PERSON FOR EACH COUNTRY OR TERRITORY
Would you like to add another key employee?
Yes
No
Key employee 1
Name
First
Last
Job title
Address
Phone
Email
Would you like to add another key employee?
Yes
No
Key employee 2
Name
First
Last
Job title
Address
Phone
Email
Would you like to add another key employee?
Yes
No
Key employee 3
Name
First
Last
Job title
Address
Phone
Email
Would you like to add another key employee?
Yes
No
Other key employees
Fill in Name, Job Title, Address, Phone and Email per key employee
ICMA Rules & Regulations
1. Ensure that our publishing company is in line with ICMA Membership criteria.
2. Accept any sanctions enforced by the Board of Directors, according to the following stages:
I. written formal warning
II. pecuniary fine determined by the Board of Directors
III. suspension
IV expulsion
3. Pay all invoices from ICMA in due time, assuming that they are in accordance with decisions made by the Board of Directors
4. All memberships are automatically renewed annually and you must give ICMA 1 month written notice prior to the renewal date should you wish to terminate your membership.
5. Send a copy of relevant papers or website access details to ICMA Head Office with our application.
6. Accept all other rules and regulations which form the Articles and Bylaws of ICMA, or which are agreed upon at any Conferences, and any modifications to them, as long as they are made in accordance with the ICMA Articles and Bylaws, and which may be communicated to us through the Newsletter, website or by any other means.
Name of Company
Name of Signatory
Who do we contact with regard to this application?
Name
First
Last
Email
I declare that all information stated is true. We agree to all ICMA Statutes and Regulations, if we become a member. We understand that we may be obliged to present our application to the ICMA Board of Directors and Membership.
I agree
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