SocAMLPro Membership Application

*Your name as you
wish to be addressed
in correspondence:

*Description:

*First Name:

Middle Initial:

*Surname:

Family name, surname, etc.

*Your email address:

Note that only corporate or educational establishment email addresses are acceptable. Free or anonymous email accounts such as hotmail, msn, gmail, etc are not acceptable.

*Job Title:

*Company / Government
Department /
Educational
establishment:

*Office Address Line
One:

Building number, Floor Number and Road Name.

Office Address Line
Two:

*Office Town:

*Office Post Code:

*Office Telephone
(general):

Office general line. Insert full international code e.g. +852 for Hong Kong plus area code and number.

*Office Direct
Telephone Number:

Full telephone number including country code, area code and number.

*Office Fax Direct:

Full fax number including country code, area code and number.

*Supervisor's Name
(for reference):

By submitting this form you agree that we may contact your supervisor to obtain confirmation of the information contained in this application.

*Supervisor's Direct
Telephone Number:

Full direct telephone number including country code, area code and number.

*Supervisor's Direct
email:

This must be a corporate address. Free and / or anonymous email addresses e.t. hotmail, msn... are not accepted.

*Hone Address Line
One:

We need your home address in case you leave your employment or educational establishment and they will not provide us with your new details.

Home adress line 2:

*Home Address - Town:

*Home Address -
County / State (in
full):

*Home Address -
Country:

*Please bill:

*Please write to me
at:

*I wish to apply to
be a member at the
following grade:

*Do you claim a
joining fees waiver?:

*Do you claim a fees
reduction?:

A least developed country is one named a such by the United Nations. Students and consultants are not entitled to a discount under this classification.

*Describe your
experience and
qualifications.:

(chars left: 5000)

In this section, set out your experience and qualifications making certain to demonstrate your entitlement to the specific grade of membership applied for (hint: refer back to FAQs to be sure).Maximum 5000 characters. Note the character count above the box to help you. You may prefer to prepare this section in a word processor and then copy and paste into this box.

Optional: Would you
be willing to aid in
the setting up of a
local branch (either
country, district of
city depending on
the circumstances)
and to serve on its
management
committee?:

Optional: Would you
be interested to
join a global
special interest
group e.g. money
transmitters, retail
bankers, insurance
brokers, etc. if the
Society formed such
groups?:

Declaration:

I submit this application declaring all information contained herein to be true. I agree that you may contact my supervisor as named herein for confirmation of all relevant facts. I agree to pay the required joining fee and membership fee upon acceptance of my application. I confirm that I will abide by the Regulations of the Society and any branch I may be attached to and that my membership may be terminated for breach or revoked in the event that information in this form is found to be untrue or for misconduct. I accept that the acceptance or rejection of this application is at the sole discretion of The Society of Anti Money Laundering Professionals.

*Signed (Type your
name here to signify
acceptance and
confirm that you are
the person to whom
this form relates):

*Date of Application:

/ /

*Image Verification:

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