Membership Application

Name of Organization*

Applicant e-mail

Applicant Contact Name & Address

Street Address Line City State / Province / Region Postal / Zip Code Country

Is your Organisation the main entity for authorising Mines Rescue training in your jurisdiction?

Is your Organization the main entity for conducting Mines Rescue training in your jurisdiction?

Is your Organization the main entity that responds to mine emergencies in your jurisdiction?

Is your Organisation answerable to a higher entity in relation to Mines Rescue matters, that is, training and mobilisation of mines rescue personnel?

If your Organization answers to a higher entity, name that higher entity:

Are there other Bodies / Organisations / Institutes in your country that perform the same or similar mines rescue activities to your Organisation?