Application

APPLICATION
ADDITIONAL
CONFIRM
RECEIPT / INVOICE

Individual Membership Application

Email *

Password *

Confirm Password *

Membership Information

Selection of membership category *

Note: Digital Membership - A digital membership is intended for those living outside of North America, and does not provide a physical copy of the CIM magazine or reduced convention rates

If you would like to purchase Multi-year membership, please select the number of years below.

Promotional Code

Contact Information

Salutation *

Birthdate *

First Name *

Last Name *

Primary Phone *

Preferred language *

Additional Phone

Billing Address

Address 1 *

Address 2

Country *

Province

Town/City *

Postal Code *

Mailing Address

Same as billing address.

Address 1 *

Address 2

Country *

Province

Town/City *

Postal Code *

Additional Information

School Name *

Program Name *

Year of Graduation *