IAIP/CPCU CE Signup

* Indicates required field

IAIP/CPCU Class Selection

CE Class Sign Up -- Mark your Selection *

10/07 2022 Homeowners Policy - in person I will be staying for lunch IAIP Member CPCU Member

Please Note:
Your seat is not guaranteed until payment has been made.
After registration is submitted you will automatically be directed to the payment page.

Complete class registration by clicking the green "Register For Class" button in the bottom right of this form.

Your Information

First Name *

Middle Initial *

Last Name *

Preferred Name *

Personal Email *

Business Email *

Mobile Phone Number *

Business Phone Number *

System ID / License Number *

Organization *

City *

Zip Code *

State *

Current Designations *

Will someone besides you be paying the invoice? *

Yes, someone else will be paying No, I am paying

Comments *

Your seat is not guaranteed until payment has been made.
After registration is submitted you will automatically be directed to the payment page.

PLEASE NOTE: No information provided will be shared with others and will only be used to contact the registrant.

Email is our default & preferred method of communication. Please provide your business AND personal email. This is necessary as we may need to contact you outside normal work hours or in the event there is an error in your email address. Cell phone numbers may be used to text if email bounces back. As a final means of contact, we will call during work hours if possible.

Test