ERIN Membership Registrations

Thank you for your interest in joining Empirical Research Institute of Nigeria.

Membership Category

Corporate/Institutional Member Membership Fee: ₦75,000.00

Corporate/Institutional Member - Form

Fill/Update your registration form for submission

Passport

Bio Data

First NameMiddle NameLast Name Place of BirthGenderDate of Birth Marital StatusNationalityState of Origin Local Government AreaNext of Kin NameNext of Kin Address Current Postal AddressResidential AddressEmail Address Telephone

Educational Qualifications

Primary SchoolPrimary School Year Passed OutPrimary School Certificate Obtained Secondary SchoolSecondary School Year Passed OutSecondary School Certificate Obtained Higher InstitutionHigher Institution Year Passed OutHigher Institution Certificate Obtained Higher Institution Course OfferedHigher Institution Final GradeHigher Institution Second Degree (if any)

Professional Qualifications

Do you belong to any Professional Institute like ours?If yes, Name of the InstituteYour Status in the Institute Quote your Membership Number of the InstituteYear of Qualification

Declaration

I, ________, solemnly declare that all information given by me in this application form are true and correct, and that I will abide by the professional ethics, integrity and competence requirements of ERIN.

SignatureDate

Corporate/Institutional Member Fee: ₦75,000.00