FORM

INDIVIDUAL MEMBERSHIP APPLICATION

FIRST NAME(S)

LAST NAME

GENDER

PROFESSION

FIRM/COMPANY

POSTAL ADDRESS

OFFICE ADDRESS

TELEPHONE/MOBILE

Do you have prior knowledge and practical experience of corporate restructuring and insolvency?

If yes: Please indicate years of Restructuring and Insolvency practice:

MEMBERSHIP SUBSCRIPTION

REGISTRATION FEES

ANNUAL SUBSCRIPTION

TOTAL

My cheque is enclosed :

I have made a transfer to GARIA’s account

Please indicate preferred method of contact

DECLARATION

I wish to be a member of the Ghana Association of Restructuring and Insolvency Advisors (GARIA). If accepted, I agree to be bound by the constitution of the Association. I will pay all approved fees at the rate in force and I declare that all statements made by me on this Application Form are correct.

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Upload your valid gov't issued ID (Passport, National ID, Voter's ID, Driver's License)

SIGNATURE

DATE AFFIRMED

FORM

INDIVIDUAL MEMBERSHIP APPLICATION

MEMBERSHIP SUBSCRIPTION

DECLARATION

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