IUMI 2009 Spring Meeting

                   

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 $750.00 per student for AIMU Members
Tuition is $1,125.00 per student for AIMU Members Agents & Brokers
Tuition is $1,500.00 per student for Non-Members of AIMU
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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