Introduction to Ocean Marine Insurance Registration Information

Print out the following page and either mail it in with a check payable to American Institute of Marine Underwriters, 14 Wall Street, New York, NY or fax with Credit Card Information filled in below to fax number: (212) 227-5102.

 
First Name:  
Last Name:  
Title:  
Company:  
Business Address:  
City:  
State:  
Zip Code:  
Telephone:  
Fax:  
Email Address:  
License #:  

(Last 4 digits of your SS# is needed for New York - this can be given at the course)

 

Tuition is $800.00 per student for AIMU Members
Tuition is $1,175.00 per student for AIMU Members Agents & Brokers
Tuition is $1,550.00 per student for Non-Members of AIMU

 

Participation:      r Attend On-Site   r Distance Learning*

* Distance Learning is not approved for CE credits.  To earn CE, you must attend onsite. 
  Codes and handouts will be e-mailed the day before the course.

 

Number of Participants:  
Total Fee Paid:  

Method of Payment

Check: Please make payable to:  American Institute of Marine Underwriters
            (please note student's name and course on check stub)

Credit Card (Circle One)    
MasterCard      AMEX    Visa    Diners
 

Cardholder Information

First Name:
Last Name:
Card Number:
Exp. Date:

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