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Education Payment Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Please note that we are currently unable to process plaque orders due to supplier issue.
This form is to be used when making a final payment using Credit Cards only.
IF YOU DO NOT SEE YOUR PAYMENT OPTION LISTED BELOW, PLEASE CALL JANET PANTALEON DIRECTLY AT (909)406-8158 TO DISCUSS YOUR OPTIONS
If submitting payment by check please click here to download the form required for mailing a payment.
Education Payment Form By Check
This form does not replace the
Application for Admission
. Please use the Application for Admission when enrolling in either CMC or MMC Certification Program or EPP Programand submitting the required $50 non-refundable admission fee.
Member ID Number
*
If you do not know your member ID number please contact us at (909)944-4162 and a team member can assist you.
Last Name
*
First Name
*
Current Job Title
*
Municipality or Government Unit
*
Mailing Address
*
City
*
State/Province
*
Zip/Postal Code
Country
Email Address
*
Phone Number
*
Remaining CMC Certification Fees
Please note that we are currently unable to process plaque
Payment
-- Select One --
Remaining CMC Balance - $75.00
CMC Balance plus optional plaque fee of $40 - $0.00
Quantity
Shipping Cost
Taxable
Remaining MMC Certification Fees
Please note that we are currently unable to process plaques
Payment
-- Select One --
MMC Payment - $100.00
MMC Payment $100.00 with optional plaque ($40) - $0.00
MMC Payment - $300.00
MMC Payment $300.00 with optional plaque ($40) - $0.00
MMC Payment - $350.00
MMC Payment $350.00 with optional plaque ($40) - $0.00
Quantity
Shipping Cost
Taxable
Optional Plaque (if not purchased above)
Please note that we are currently unable to process
Payment
-- Select One --
CMC Plaque - $0.00
MMC Plaque - $0.00
Quantity
Shipping Cost
Taxable
Replacement Certificate
Payment
-- Select One --
CMC Certificate - 5.00
MMC Certificate - 5.00
Quantity
Shipping Cost
Taxable
IIMC Foundation Education Contribution
Amount
-- Select One --
Foundation Contribution - $5.00
Foundation Contribution - $10.00
Foundation Contribution - $15.00
Foundation Contribution - $20.00
Foundation Contribution - $25.00
Quantity
Shipping Cost
Taxable
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