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Independent Membership Details

Independent Member Application
NB: Membership applications incur a non-refundable application fee, which is payable when submitting this form and before the application is considered. 

Confidentiality

All reporting regarding membership is at aggregate level. All details and information submitted is strictly confidential.

About You

Curriculum Vitae

Please upload a PDF of your current CV, including the details and email addresses of at least three contactable references, as well as copies of your qualification certificate(s).

Maximum file size: 10MB

0 of 500 max words
Name
Name
First
Last
Gender
Please note that this question is included because we have to report on this, at aggregate level, to government agencies in South Africa

What You Do

The role that you fulfil most of the time at work.
SECTOR(S) in which you have worked in the last 12 months
If you are on user/client/buyer side, this question applies to the work you have done internally, as well as commissioned externally. Categories are based on the ESOMAR global classification system.
Yes
No
Manufacturing: Consumer Non-Durables (FMCG)
Manufacturing: Consumer Durables
Manufacturing: Pharmaceutical products and services (Rx – prescription)
Manufacturing: Automotive
Manufacturing: Other
Business-to-business and industrial
Wholesale and retail (incl. oil, commercial farming, agriculture)
Financial services
Utilities (incl. gas, electricity, water, private and public postal services, etc.)
Telecommunications and Information and Communications Technology
Public sector, academic and public institutions, NGOs
Media, entertainment, tourism and hospitality
Advertising agencies, Strategy and communications companies, Brand consultants
Research institutes
QUANTITATIVE methods you have worked with in the last 12 months
Categories are based on the ESOMAR global classification system.
Yes
No
Postal mail self-completion questionnaire
Telephone interviewing (CATI) (including CATI to mobile)
Face-to-face interviewing (PAPI/CAPI)
Self-completion questionaire using an online device
Online traffic / audience measurement, including website measurement
Automated digital/electronic including retail audits and media measurements and interactive voice recording interviews
QUALITATIVE methods you have worked with in the last 12 months
Categories are based on the ESOMAR global classification system.
Yes
No
Group discussions / focus group interviews
In-depth (individual) interviews
Communities and panels
Self-reporting (e.g. vox pops, blogging, written diaries, photo diaries)
Observation (e.g. ethnography, immersions, shopper research)
BIOMETRIC MEASURES you have worked with in the last 12 months
Categories are based on the ESOMAR global classification system.
Yes
No
Facial coding
Eye-tracking
Functional magnetic resonance imaging (fMRI)
Positron emission tomography (PET)
Electroencephalography (EEG)
Steady state topography (SST)
Transcranial magnetic stimulation (TMS)
Electro Dermal Activity (EDA)/galvanic skin response
Electromyography
Electrocardiography (ECG)
Implicit Association Test (IAT)
DESIGNS you have worked with in the last 12 months
Categories are based on the ESOMAR global classification system.
Yes
No
Ad hoc research
Omnibus (syndicated) surveys
Panel research
Other continuous tracking research

Your Contact Info

Postal Address (Personal)
Postal Address (Personal)
City
State/Province
Zip/Postal
Country
Physical (Delivery) Address (Personal)
Physical (Delivery) Address (Personal)
City
State/Province
Zip/Postal
Country

Terms and Conditions

I hereby certify that:

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