AMN Online Membership Application Form                          
Please provide the following details to be considered for membership. (Please remember also to click on the submit button below when done).
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AMN is a not for profit, apolitical NGO creating a platform for mining industry professionals; to help each other; to meet, learn and earn; through advocacy, conferencing, training, fora, etc.  
First Name *
Please provide official name you can support with an Identity Card when required to do so
Middle Name/Other Names
Last Name/Surname *
Please provide how you want your name on your certificate
Gender
Clear selection
Email Address *
Telephone Number *
Alternate Telephone Number
WhatsApp Number
if different from Telephone Number above
Current Location/Address *
Please provide ONLY Country and City (Town or Suburb or County)
How did you hear about the Accra Mining Network? *
Preferred medium of communication *
Please tick all that apply
Required
Would you like to join the AMN WhatsApp group? *
You will be automatically added with a YES choice below.
Academic Qualifications *
Please tick all that apply
Required
What is your profession? *
Number of years of professional experience
Educational Background *
Last three schools, colleges, institutions or universities attended
Employment History *
Most current on top
What are your areas of expertise/interests?
Areas you can be consulted on when the need arises
Sofware and ICT know how *
Which softwares do you know well
Do you belong to any professional associations?
eg. AusIMM, GhIG, AAPG, SPE, SEG, GSA, etc.
Which Category of Membership would you like to be considered for *
Name and contact address, phone numbers and email address
Date *
Today's Date
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