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Corporate Member Online Application

Payment Instructions: Please note that the next screen will continue with payment by credit card via PayPal, keep your credit card ready before proceeding.

Any corporation or marketing department may apply to become an IIMP™ corporate member. In order to qualify for the corporate membership, a minimum of $525.00 (U.S. Funds) (discounted fee of $262.50 will apply, if existing member of any recognized marketing associations) to be paid which will cover fee for five individuals (If all five members are not registering at the initial time, the rest of them can be registered anytime within 12 months period from the first registration date).

• Corporate Member registration fee for each new member: $105.00 (U.S. Funds).
• Corporate Member renewal fee for each member: $95.00 (U.S. Funds).
• Discounted annual fee for existing members of any recognized marketing
associations: $52.50 (U.S. Funds).


Corporate Information

Company Name:

Website:

Phone:

Address:

City:

Postal/Zip Code:

Province/State:

Country:


Please check box, if this is your preferred mailing address.



Individual Information

Surname:
Given Name:

Middle Name:

Your Job Title:

Home Phone:

Cell Phone:

Email:

Address:

City:

Postal/Zip Code:

Province/State:

Country:


Please check box, if this is your preferred mailing address.



Online Login Information

Login Name: 5-12 letters/numbers

Password: 5-12 letters/numbers




Payment Information

• Please note: the next screen will continue with credit card payment by PayPal.
• Corporate Member registration fee for each new member: $105.00 (U.S. Funds).
• Corporate Member renewal fee for each member: $95.00 (U.S. Funds).

• Fee payment for minimum five members ($525.00) required to qualify.
• Discounted fee payment for minimum five members ($262.50) required to qualify.

Membership Fee:

Payment Status:




Membership Information with other Marketing Association
(Complete this section, if applying for special discount)

Association Name:

Your Membership No:

Website:

Contact Name:

Phone:

Address:

City:

Postal/Zip Code:

Province/State:

Country:


Check box, in order to authorize us to verfiy your memberhsip information


Authorizations

Include your information in IIMP™’s online membership directory.
Email you information about IIMP™’s upcoming event and activities.
Permit third parties to contact you about promotional information.
Accept IIMP™'s Membership Agreement.


Comments/Questions (optional):



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