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membership

Application Form

 

Name *
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Address *
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Country *
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Facsimile
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Email *
Member Type *

References
FOR ASSOCIATE MEMBERSHIP APPLICATIONS ONLY:

We require two references -

BOTH REFEREES’ DETAILS MUST BE FROM SHIP MANAGEMENT OR SHIP OWNING COMPANIES and one must be an existing member of IMPA.

Referee1 Name
Referee1 Position
Referee1 Company
Referee1 Address
Referee1 Country
Referee1 Telephone
Referee1 Email
Referee2 Name
Referee2 Position
Referee2 Company
Referee2 Address
Referee2 Country
Referee2 Telephone
Referee2 Email
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