Ready to Become a GMMAN Member? Complete the Form Below Name Company Name Email Address Phone No Address Town/City State Country Membership Category StudentIndividualCompany Business Category MinersCuttersWholesalersRetailersJewelersOthers If others please specify Reference Your Reference must be a good standing individual or company in the Mining Industry Your Referee Name or Company Name Your Referee Email Address Your Referee Phone No Your Referee Address Terms and Conditions I, the undersigned, hereby attest that the information provided in this application is complete and correct. In the event my application for membership is accepted, I agree to conduct my professional practice within the guidelines of the Cod se of Ethics and resolutions of GMMAN Your Full Name (This also serve as your signature for this Form) Full Name Date
