Membership Registration

Infrastructure Maintenance Awareness Team (IMAT-FUTA)

"Building a Culture of Care for Campus Infrastructure"

INSTRUCTIONS: Please fill out this form completely. All fields marked with * are mandatory.

Section A: Personal Information

Full Name (Surname First) *

Matriculation Number *

Gender *

Male Female

Current Level *

200L 300L 400L 500L

Email Address *

Phone Number *Must be exactly 11 digits

Residential Address on Campus

Is your CGPA above 3.00? *

Yes No

Expected Year of Graduation

Any Previous Leadership Experience?

Yes No

Why do you want to join IMAT? *

How much time can you commit per week? *

2-4 hours per week 5-7 hours per week 8-10 hours per week More than 10 hours per week

Provide ONE academic reference (Lecturer / Course Advisor):

Name of Referee

Department

Referee Email

Referee Phone

I hereby declare that:

All information provided in this form is accurate and complete.
I understand that IMAT operates strictly as an advocacy team, not an Aluta group.
I commit to maintaining professional conduct and academic excellence.
I am willing to undergo mandatory HSE training before active participation.
I understand that membership may be revoked for academic misconduct or unprofessional behaviour.
I agree to dedicate time to team activities without compromising my academic performance.

I agree to all the declarations above *

Applicant's Full Name (as signature) *

Date *

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