Individual Membership Application

I wish to apply for (please tick relevant box)

Professional member (Rs.5000/-)

Member (Rs. 5000/-)

Associate Member (Rs. 3000/-)

Student Member (Rs. 1000/-)

Please state your preferred address of correspondence

PERSONAL DETAILS

Surname

Other Name

Home Address

Mobile Number

Phone Number

Email

Date of Birth

Current Employment Details

Job title / Position

Department

Company Name

Company Address

Phone Number

Employment Email

Industry Experience - For Practitioners

How many years of cumulative research experience do you have?

For MR Users

How many years of cumulative experience in using Research as a decision making tool do you have?

For Lectures

How many years of cumulative experience in lecturing do you have

Previous Work Experience

Name of Organisation

Job title / Position

No. of years of experience

Academic & Professional Qualifications

Name of qualification

Name of University / Institute

Year of completion

If Student – Study Programme Currently Undertaken

Name of University /Institute

Name of qualification

Expected completion date

TERMS AND CONDITIONS

1) This membership is valid for a period of 12 months from date of acceptance of the application

2)This is an individual membership and hence non transferable

3) If you move out of the MR industry, your membership ceases, you are given an interim membership period of 3months (without voting right), until you reapply into a new category.

4) If membership is not renewed by paying the membership fee, within 2months of date of expiry, membership is cancelled automatically.

DECLARATION

I confirm, to the best of my knowledge, that the information given on this form is correct. I have read and agree to the Terms and Conditions above. I understand that my membership will be conditional upon abiding by the MRS Sri Lanka code of conduct.