Affiliate Membership Application

This category welcomes individuals who do not hold formal health qualifications but who share IIMHE’s mission. Affiliate Members who are holders of an IIMHE Kite Mark certificate may apply to participate in our educational events, volunteer activities, and supportive community initiatives.

Full Name

Pref. Title

Date of birth

Gender

Country of Residence

Address

Mobile/Phone

Current Occupation

Place of Work

Professional / Academic Titles

Introduced by (Optional)

Preferred Communication Method

Consent for Name & Professional Details to Appear in Members-Only Directory

Would you be interested in speaking at IIMHE events?

Would you be interested in contributing to research or publications?

Dietary or Access Requirements for Events

Motivation for Membership

Consent to receive newsletters and updates

I confirm the information provided is accurate and complete.

I agree to uphold the IIMHE Code of Ethics and Standards.

I consent to IIMHE storing and processing my personal data for the purposes of membership administration.

Digital Signature

Date

Affiliate Membership Application

Important Links

Essential Links

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