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Membership Type *
Your Name *

Last Name:
FirstName
Full Middle Name:

Your E-Mail Address *

to you at this address
Sponsor Code*
Put IMG100 if you do not know your sponsor's code
Sponsor Name*
Is Under BAP(Business Acquisition Program)
Custodian Code
Put IMG100 if you do not know your custodian's agent code
Custodian Name
Name of Trainor (if applicable)
Forwarding Address
PERSONAL INFO
Gender *

Birth Date *
Telephone
Mobile
Civil Status*



Spouse Name
Spouse Code*
Put IMG100 if you do not know your spouse's code
Nationality*
TIN
Tax Identification Number
Employer*
Educational Attainment*

PHILIPPINE ADDRESS INFO
Philippine Address
Philippine Address
Philippine City
Philippine Region
Philippine Zip
CURRENT ADDRESS INFO





HAVE YOU BEEN:
A Member of IMG Before?
An Agent of Life Insurance Co.?
An Agent of Non-Life Insurance Co.?
An Agent of Health Care/HMO Co.?
MEMBER SIGNATURE

International Marketing Group(IMG)
Acknowledgement of Prospective Associate


The undersigned individual has expressed an interest in becoming a member (“Associate”) of IMG sales force of independent contractors. To induce IMG to allow the undersigned the opportunity to become an associate, the undersigned hereby acknowledges and agrees as follows:
  • That, to become an Associate, he or she will be required to enter into an Associate Membership Agreement (“Membership Agreement”) with IMG, pursuant to which he or she will become authorized to engage in the business of selling insurance and other financial service products and services offered by or through IMG;
  • That preserving the integrity of the hierarchical structure of IMG sales force, is an essential element to the success of all IMG Associates;
  • That he or she has been advised that new Associates of IMG will be assigned to specific hierarchical positions within the IMG sales force based on the IMG Associate (“Recruiter”) who is responsible for recruiting each prospective Associate to join IMG and that such hierarchal position is designated by reference to the name of the IMG Marketing Director, to whom such a new Associate is assigned;
  • That, if he or she becomes an Associate of IMG, he or she shall be assigned to a hierarchal position within the IMG sales force based on the name of the IMG Marketing Director set forth below;
  • That, by signing below, he or she intends to be and will become legally bound by such hierarchal assignment from the date set forth below, and that such assignment will remain in effect for so long as he or she remains an IMG Associate and cannot be changed without the consent and approval of IMG; and
  • That this Acknowledgement shall continue in effect indefinitely and shall survive his or her execution of a Membership Agreement if he or she does in fact decide to become an Associate.

The term IMG, as used herein, refers to International Marketing Group, a Philippine corporation, or any transferee, assignee, or successor to same, including a Philippines limited partnership in which said corporation is or becomes a general partner


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