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Membership Type *

ME - IMG Membership ( USD 175 - One time joining fee for Bahrain based members )
Bahrain - IMG Online Membership

Your Name *

Last Name:
FirstName
Full Middle Name:

Your E-Mail Address *

A confirmation email will be sent
to you at this address

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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
I hereby declare that I have read and understood IMG's Guidelines on Business Acquisition Program (BAP) and that I am willingly abiding by the same. I further declare that in the event that this present BAP should be found to have violated said Guidelines, IMG shall have the right to take appropriate action such as but not limited to having this BAP cancelled.
Signature*	Member's Signature

Name of Trainor (if applicable)

Forwarding Address

PERSONAL INFO

Occupation/Profession *

Gender *

Male
Female

Birth Date *

Telephone

Mobile

Civil Status*

Single
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Spouse Name

Spouse Code*

Put IMG100 if you do not know your spouse's code

Nationality*

TIN

Tax Identification Number

Employer*

Educational Attainment*

Elementary
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PHILIPPINE ADDRESS INFO

Philippine Address

Philippine City

Philippine Region

Philippine Zip

CURRENT ADDRESS INFO

Country*

State*

City*

Street*

ZIP*

HAVE YOU BEEN:

A Member of IMG Before?

Yes

An Agent of Life Insurance Co.?

Yes

An Agent of Non-Life Insurance Co.?

Yes

An Agent of Health Care/HMO Co.?

Yes

MEMBER SIGNATURE

Acknowledgement of Prospective Associate

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

I hereby declare that at the time of my application for international membership with IMG, I am residing or working outside the territorial jurisdiction of the Philippines.

I understand that in the event of any misrepresentation on my part, IMG reserves the right to terminate my membership without any right to refund of the membership fee and forfeiture of all benefits afforded to me by reason of my membership with IMG.

Signature*