Membership Application Form - Provisional

INTERNATIONAL COUNCIL OF MANAGEMENT CONSULTING INSTITUTES

Secretariat: C/O Maurer & Stager AG

Fraumunsterstrasse 17/Postfach 318

CH – 8024 Zurich

Website: http://www.cmc-global.org/ , email: cmc-global@cmc-global.org

Provisional Membership Application

GENERAL INSTITUTE DATA

Institute Name *

Country *

Postal Address of Institute Office

P.O.Box *

Postal Code *

City *

Street *

Building # *

Legal Address if different from above for express mail delivery *

Same Address

New Address

P.O.Box *

Postal Code *

City *

Country *

Street *

Building # *

Telephone No *

Please note that only numbers are accepted in this field, therefore, only enter numbers with no spaces or characters. For example, a no. with international codes would be entered as follows: 0012376800912, do not use (+) or (-) or spaces before or between numbers.

Website *

E-mail *

President’s/Chairs’ Name *

Expiration of term *

Month

Day

Year

Name of President's/Chair’s Consulting Practice *

President’s/Chair’s Address

P.O.Box *

Postal Code *

City *

Country *

Street *

Building # *

Tel No *

Email *

Names and titles of office staff members

Full-time staff *

Part-time staff *

Note: If there is no office, please give the names, titles & addresses of those who administer the Institute (for example: Executive Director, Secretariat…etc.:

Does the Institute have a regional, chapter or branch structure? *

Yes

Specify *

Please specify the names, titles and terms of office of current national office holders:

Treasurer *

Start *

Month

Day

Year

Finish *

Month

Day

Year

Secretary of the Board *

Start *

Month

Day

Year

Finish *

Month

Day

Year

First Vice President(s)/Board Members

Start

Month

Day

Year

Finish

Month

Day

Year

Second Vice President(s)/Board Members

Start

Month

Day

Year

Finish

Month

Day

Year

Third Vice President(s)/Board Members

Start

Month

Day

Year

Finish

Month

Day

Year

Fourth Vice President(s)/Board Members

Start

Month

Day

Year

Finish

Month

Day

Year

Fifth Vice President(s)/Board Members

Start

Month

Day

Year

Finish

Month

Day

Year

Sixth Vice President(s)/Board Members

Start

Month

Day

Year

Finish

Month

Day

Year

Other (specify)

Start

Month

Day

Year

Finish

Month

Day

Year

LEGAL AND PROFESSIONAL STATUS

Specify your Institute's legal status (e.g. Inc., Plc., Limited by Guarantee, etc.): Please include registration document with this application *

Please include registration document with this application *

Files must be less than 2 MB.
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Date of Formation *

Month

Day

Year

How does the government of your country acknowledge your Institute? *

Organization Sustainability

Please provide a short history of the Institute to include:

a. Organization Strategy: *

b. Organization Structure and Governance (attach your By-laws) *

Please attach your By-laws *

Files must be less than 2 MB.
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In maximum 150 words, summarize your motivation / objective for applying for ICMCI membership: *

Please attach to this application a

a. Summary of your budget vs. actuals for the past 3 years *

Files must be less than 2 MB.
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b. The proposed budget for the coming year *

Files must be less than 2 MB.
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Please list the names of committees and sub-committees:

First Committee

Second Committee

Third Committee

Fourth Committee

Fifth Committee

First Sub-committee

Second Sub-committee

Third Sub-committee

Fourth Sub-committee

Fifth Sub-committee

Membership Information

Please describe the type or field of consulting your members must provide to qualify for membership: *

Please define your institute or organization in terms of its membership, e.g. *

a. institute of individual management consultants

b. association of management consulting firms (i.e. corporate members only)

c. institute of individuals with facilities for corporate (firm) membership

d. association of firms with provision for individual memberships

Body of Knowledge: Please describe the basic body of knowledge that your Institute requires its members to possess in common. (Please enclose a copy of any published material on your body of knowledge.) *

Copy of any published material on your body of knowledge *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx ppt pptx xls xlsx.

Definitions

a. Give your definition of a management consultant *

b. Give your definition of a certified (i.e. fully qualified) management consultant. *

Does the Institute require applicants to have a recognized degree and/or professional qualification for all or certain grades? *

Yes

Specify *

Current membership figures

a. No. of Individual Members *

b. No. of Corporate Members *

c. No. of CMCs if applicable *

d. Add any type of membership you carry other than above and provide no. of members in each category:

Name of membership *

Number of members *

Is Institute membership a mandatory requirement to practice management consulting in your country? *

Yes

Give details *

Please answer "Yes" or "No" to the following questions. (Please enclose a copy of published Institute material where relevant.):

Does the Institute have a code of professional conduct, or ethics? *

Yes

Attach file

Files must be less than 2 MB.
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Are there complaints and disciplinary procedures in existence to support the code? *

Yes

Attach file *

Files must be less than 2 MB.
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Have these procedures ever been employed? *

Yes

Attach file *

Files must be less than 2 MB.
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Is there an Institute training and development program with supporting activities? e.g. seminars, conferences, workshops, etc. (specify) *

Yes

Give details *

Attach file

Files must be less than 2 MB.
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Does the Institute provide a library or information service for members? *

Attach file

Files must be less than 2 MB.
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Note: Please enclose application forms and support information for each grade including general information concerning membership and the membership process.

Market Information

Other Organizations: Please give name & address of any other organization in the same country with individual (specify) and/or corporate (specify) management consulting members.

1- Name *

2- Type *

Attach file

Files must be less than 2 MB.
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3- Address *

Are there any International Consulting Companies operating in your country? *

Yes

Please provide names *

Attach file

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx ppt pptx xls xlsx rar zip.

List 3 to 5 key industry trends which might significantly impact on the management consulting practice and your institute in your country, i.e. Manufacturing, Financial, Telecommunication, Mining…etc.

First Industry Trend *

Second Industry Trend *

Third Industry Trend *

Fourth Industry Trend

Fifth Industry Trend

Please list important Management Consultancy disciplines and trends in your country, i.e. Financial, Governance, HR, Strategy, Operations…etc.

First *

Second *

Third *

Fourth

Fifth

Sixth

Seventh

Eighth

Ninth

Tenth

Are your members operating: *

Nationally

Regionally

Internationally

Combination

Specify *

Attach file

Files must be less than 2 MB.
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Are there donor, financial institutions, or funding programmes supporting the Management Consulting Profession in your country? *

Yes

Name *

Website *

Attach file

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx ppt pptx xls xlsx rar zip.

Do you have access to any donor, financial institution, or funding programmes as an institute? *

Yes

Name *

Website *

Attach file

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx ppt pptx xls xlsx rar zip.

Do your members have access to any donor, financial institutions, or funding programmes? *

Yes

Name *

Website *

Attach file

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx ppt pptx xls xlsx rar zip.

Please list five top National Management Consultancy service providers in your country (excluding international companies listed in 2 above).

First service provider *

Website: *

Second service provider *

Website: *

Third service provider *

Website: *

Fourth service provider *

Website *

Fifth service provider *

Website *

Attach file

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx ppt pptx xls xlsx rar zip.

What percentage of the total number of management consultants in your country comprises Institute members? *

Attach file

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx ppt pptx xls xlsx rar zip.

Note: please attach or provide a web link to any supporting documents to above if applicable.

STATEMENT

I certify that:

All statements made by me in this application and the documents enclosed herein are correct. *

All statements made by me in this application and the documents enclosed herein are correct.

I have arranged for the application fee to be paid to ICMCI. *

I have arranged for the application fee to be paid to ICMCI.

Our Institute, once admitted, will comply with the ICMCI Constitutions and By-laws, Membership requirements, and Code of Conduct. *

Our Institute, once admitted, will comply with the ICMCI Constitutions and By-laws, Membership requirements, and Code of Conduct.

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Membership Application Form - Provisional

Provisional Membership Application

Postal Address of Institute Office

President’s/Chair’s Address

Names and titles of office staff members

Please specify the names, titles and terms of office of current national office holders:

Definitions

Current membership figures

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