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Education Payment Form
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This form has been modified since it was saved. Please review all fields before submitting.
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 KELLIE SIGGSON DIRECTLY AT (909)944-4162 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 and submitting the required $50 non-refundable admission fee.
Member ID Number
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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
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First Name
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Current Job Title
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City
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State/Province
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Email Address
*
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*
Remaining CMC Certification Fees
Payment
-- Select One --
Remaining CMC Balance - $75.00
CMC Balance plus optional plaque fee of $40 - $115.00
Quantity
Shipping Cost
Taxable
Remaining MMC Certification Fees
Payment
-- Select One --
MMC Payment - $100.00
MMC Payment $100.00 with optional plaque ($40) - $140.00
MMC Payment - $300.00
MMC Payment $300.00 with optional plaque ($40) - $340.00
MMC Payment - $350.00
MMC Payment $350.00 with optional plaque ($40) - $390.00
Quantity
Shipping Cost
Taxable
Optional Plaque (if not purchased above)
Payment
-- Select One --
CMC Plaque - $40.00
MMC Plaque - $40.00
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
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Shipping Cost
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