MIS Membership Application Please enable JavaScript in your browser to complete this form.Select Required MIS Membership: *Ordinary Membership $50.00Junior Membership $40.00Senior Membership $40.00Corporate Membership $600.00Membership to The Make It Safe is available upon the payment of the subscribe fee of: (A) Ordinary Membership $50.00, (B) Junior Membership, $40.00 Under 18's (C) Senior Membership, $40.00 Over 60's (D) *Corporate Membership, $600.00 Partnerships, Corporate Bodies, Trade Associations, for the period of one year upon approval. Name *FirstLastDate of Birth: *Enter D.O.B in format: DD-MM-YYYYADDRESS: *Email *EmailConfirm EmailPhone Number: *Please enter contact numbers separated by comma(,).Whatsapp Number:GENDER: *FEMALEMALEDRIVERS LICENCE / PERMIT TYPE *I am a (Tick the applicable option) *New MemberFormer Memberwhat type of road user are you? * Driver Motorcyclist Cyclist Walker All of the Above My Special Area of Interest: (Please tick where applicable:) *EducationFundraisingLegislationProjectsCampaignsTrainingOCCUPATION *Comment or Message *Reason for joining MIS *What would you like to gain from MIS? *HOW DID YOU HEAR ABOUT US? *FacebookGOOGLEInstagramRadio AdvertTwitterWord of MouthWorkMIS Membership Agreement *FirstLast I ___________________________ agree to abide by the code of conduct listed in the MIS Constitution for members of the Association. I understand I must drive my motor vehicle or as walk as a pedestrian, placing safety first, at all times, and in compliance with the rules and regulations of the Barbados Road Traffic Act. I also promise to set a positive example in my behaviour on the roads of Barbados at all times. DATE: *By ticking this box you agree to be bound by MIS agree to abide by the code of conduct listed in the MIS Constitution for members of the Association *I AgreeNameSubmit Was this article helpful?YesNo
