MIAK - MEMBERSHIP APPLICATION FORM

Personal information

Photo gallery

First Name*

Surname*

Father’s name*

Date of birth*

day

month

year

Region*

Address*

(city/town, marz, district, street, building, apartment, number)

Telephone apartment*

Telephone cell

E-mail

Education

secondary

School

Study years

from

First higher education

School

University

Profession

Study years

from

Further Educatrion

School

University

Profession

Study years

from

Occupation

Current employer

Position

Previous work experience

MIAK programme and administrative activities

Please, select the area of MIAK programmeand/or administrative activities you are interested in:

   State and legal, democracy and human rights
   Defense, national security and foreign policy
   Public relations and communications
   Establishing relations with partner organizations and individuals and external funding
   Organization, legal and administrative
   Economy and economic development
   Tax and finance
   Social security, environment and healthcare
   Education, science, culture, youth and sports

Would you be interested in proposing, developing and encouraging new programme directions for MIAK

Yes

Personal contribution and obligations

How many hours daily/weekly can you devote to MIAK?

Additional questions

Have you had any connection with any political party acting in Armenia? If yes, please provide details

Yes

Did you have a criminal record,whether you were brought against criminal charges? If yes, please explain.

Yes

Family Status

Married

Divorced

Single

Widowed

Please, select user’s name and password for MIAK website (Latin)

User name*

Password*

* Please note, that you have to answer all questions. The incomplete application will not be accepted and the candidate will not be invited to MIAK enrollment interview.

Membership application form