2019 CMSP Registration Form

2019 CMSP Registration Form
The CMSP course has received continuing education credit approval for LNCC, CRC, CCM, CWCP, and CLE through the Louisiana Bar Association; (most states will provide reciprocity), Life & Health, Property & Casualty, Adjuster CE through the Louisiana Department of Insurance (most states will provide reciprocity), Adjuster License CE through the State of Mississippi (most states will provide reciprocity) and is applying for CLCP credit.
Name*

First NameLast Name
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Registration Type*

Workshop Only $800Complete Certification $1,200Full Re-certification $800 (earn all 24 hours of required CE, Mon-Wed)CMSP Fellow $1,000CMSP Fellow Recert $800
Session*

Baltimore, MD (September 16-18, 2019)
Payment Options*

Pay By Check (Bill Me or my Company)Pay With Credit Card (Convenience Fee Applies)
Make Checks Payable to LASIE

PO Box 4151 Baton Rouge, LA 70821-4151

***ANY CREDIT CARD PAYMENT INCLUDES A CONVIENIENCE FEE***
* If you are registering for someone else but would like the invoice sent to you, please fill out the following information.
Name

First NameLast Name
Email
example@example.com
Cancellation Policy
- 2 Weeks prior to seminar: full refund
- Less than 2 weeks: $150 cancellation fee
- There will be a $50 late fee applied to invoices more than 3 months overdue
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