IPS Nigeria Registration form – The Institute of Professional Sociological Studies (IPSS)

Section 1: Biodata

Name

First

Last

Date of Birth

Sex

Membership Category You Seek At IPSS

Nationality

For Non Nigerian

Your Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Contact

Alternative Phone Contacts

Email

Confirm Email

Please add a working email

Name of Next of Kin

First

Last

Relationship With Next of Kin

Contact of Next of Kin

Section 2: Education/Career

University/polytechnic

First

Middle

Last

Secondary School Attended

First

Middle

Last

Primary School Attended

First

Middle

Last

Professional Qualification(s)

First

Middle

Last

Working Experience

First

Middle

Last

Upload Your Credentials

Click or drag files to this area to upload. You can upload up to 9 files.

Results, certificate etc

Section 3: Reference

Professional Section accept

Recommendation

First

Last

Your Referee should be a Civil Servant, A Lecturer, a Religious Leader or someone who can attest to your character and good conduct.

Contact Address of Referee

Phone Contact of Referee

Email of Referee

MEMBERSHIP DECLARATION

I, hereby declare that all information provided in this application is true and correct. I authorize the Institute to verify any submitted documents with the relevant authorities. I agree to abide by the Institute’s bye-laws and uphold its professional ethics, integrity, and standards.

So help me God.

Click to accept the Declaration

I Accept The Declaration