Online Membership Application | Canadian Insurance Claims Managers Association

Applicant Information

*Indicates a required field.

What chapter are you applying to?*

Applicant First Name:*

Applicant Last Name:*

Personal Contact Information

Home Address:
City:

Province:
Postal Code:

Employer Information

Name of Employer:*
Employer's Address:*
City:
Province:
Postal Code:

Your Work Phone Number:*
Your Work Email:*

Is your employer:*

A General Insurance Company
A Reinsurance Company
A Company which acts for a General Ins.Co.
An Employee of a Company with a Self-Insured Retention in excess of $50,000.00
Other

Please explain:

Position Information

What is your position?*

Are you primarily responsible for the management of employees who are engaged principally in the administration of claims?*

Yes
No

Are you a permanent full-time employee?*

Yes
No

Sponsor Information

Any party requesting membership in the Canadian Insurance Claims Managers Association must be sponsored by a current active member of the association as defined in the constitution. The sponsor should have sufficient enough knowledge to attest that the applicant meets the requirements of membership.

Sponsor Name:*

Sponsor Company:*

Cost of membership is $200.0 annually plus HST where applicable. For Ontario Chapter the cost of membership is $230.00 inclusive of HST. Please note some chapters include the cost of meetings in addition to the annual membership fee. If your application is accepted you will be invoiced for the applicable amount.

Ontario HST Number: 82055 2792