New Enrollment

Membership Form

Interested applicants are requested to fill this application form and submit required documents for review.

First Name (required)

Last Name (required)

Age (required)

Email Address (required)

Mobile Number (required)

Address (District) (required)

Highest Academic Degree (required)

Highest Professional Degree (required)

Experience in Risk Management, Insurance and Social Security (in years) (required)

Field of interest (required)

a) Training b) Research c) Teaching d) Consulting

How can you contribute to NIRMA? (Write in max 30 words) (required)

Why do you apply for membership of NIRMA? (Write in max 30 words) (required)

Referee (Select member from Board Members - NIRMA) (required)

Please Upload Your Documents (required)

Citizenship Certificate Front

Citizenship Certificate Back

PP Size Photograph

Your CV