NAMIC PFMM Application



NAMIC PFMM Application

Registration Policy | Questions / Support
 PURCHASER PROFILE
* indicates required field

Purchaser:

*
First Name
todo Last Name
todo Suffix‡
  ‡ (Jr., Sr., MBA, etc.)
Company Name: *  
Job Title: *  
todo
Mailing Address: *  
Address 2:
City, State/Province *
 
Zip/Postal Code: *  
Country: *
todo
Telephone: * (ex: (xxx) xxx-xxxx)
Email: *    
todo

 FEES
Fees  


 ADDITIONAL OPTIONS
Were you referred by another PFMM?

If yes, please list his/her name and company.
List your educational experience, designation, association memberships and a short job description for your current position.
Check all the PFMM modules you have completed and include the date and location. Only modules you signed in for will qualify.



Dates and Locations

If you have registered for an event, you are subject to the terms and conditions of participation at this event as contained in the Event Participation Terms and Conditions found at http://www.namic.org/seminars/terms.asp and will be notified to such by the person completing this registration.