NAMIC's 122nd Annual Convention
This online registration system accepts both credit card and check payments.
Please enter the attendee’s email address to ensure that they receive all event correspondence, including the event evaluation.
Within the registration program you have the ability to forward the confirmation email to multiple people if desired. Confirmation is sent via
. The confirmation email includes a receipt, hotel information, cancellation policy and optional activities.
* indicates required field
(Jr., Sr., MBA, etc.)
(first name only)
Not US or Canada
District of Columbia
Prince Edward Isl.
US Virgin Islands
(ex: (xxx) xxx-xxxx)
Administrative Contact (Email or Name/Number):
(should we need to contact someone regarding this registration)
We invite all registrants to advise us of any disability and any requests for accommodation to that disability.
First Time Attendee?
PFMM/FMDC Certified Early- available to those that have
their certification - $660 (12/1/2016 - 7/24/2017)
Member Early - $725 (12/1/2016 - 7/24/2017)
Nonmember Early from Primary Insurance Company - $925 (12/1/2016 - 7/24/2017)
Nonmember Early from Reinsurer or Non-Exhibiting Vendor - $1025 (12/1/2016 - 7/24/2017)
Mon & Tues only Early - NAMIC Member Primary Insurance Company - $470 (12/1/2016 - 7/24/2017)
Mon & Tues only Early- Nonmember Primary Insurance Company - $600 (12/1/2016 - 7/24/2017)
PFMM/FMDC Certified - available to those that have
their certification - $760
Member - $825
Nonmember from Primary Insurance Company - $1025
Nonmember from Reinsurer or Non-Exhibiting Vendor - $1125
Mon & Tues only - NAMIC Member Primary Insurance Company - $570
Mon & Tues only - Nonmember Primary Insurance Company - $700
PFMM Credit at Convention
I want to earn credit for PFMM courses at Convention.
Prayer Breakfast, Sunday - 8:00 a.m.
at $40 each
Prayer Breakfast Choir
I am attending the Prayer breakfast and am interested in singing in the choir that morning. Please send me more details.
Fun Run & Walk, Tuesday - 6:30 a.m.
$50 per person
Merit Award Lunch, Monday - 11:30 a.m.
at $25 each
Golf Outing, Saturday - 8:00 a.m.
$235 per golfer
Golf Club Rental Fee
@ $60.00 per person
Club Rental Preferences
Additional Golfers (other attendees or non-registered guests)
*golf for your guest may be added to their guest registration
$235 per golfer
Please provide your assistant's name and email address, if you are paying for other golfers.
Addl. Golfer #1 Name (paid by you above)
Addl. Golfer #1 Clubs
Addl. Golfer #2 Name (paid by you above)
Addl. Golfer #2 Clubs
Addl. Golfer #3 Name (paid by you above)
Addl. Golfer #3 Clubs
NAMIC will attempt to honor, but cannot guarantee, golf pairing requests. If you have paid for other golfers, you
be paired with them.
I would like to be paired with the following golfer(s), who registered for golf on their own:
Opening General Session Flag Ceremony:
I would like to participate in the flag ceremony.
How did you learn about the Annual Convention?
NAMIC Online website
Other industry website
NAMIC electronic promotion
NAMIC printed promotion
Word of mouth
What type of company do you represent?*
Farm Mutual insurance company
Multi-line insurance company
What is the general category of your job title?*
C-Suite or Vice President
Board Officer/Board Member
Other Industry Professional
September 24-27, 2017
Colorado Convention Center
Questions / Support
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
and will be notified to such by the person completing this registration.