The Fiduciary & Investment Risk Management Association, Inc.
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Membership Application

Application Instructions
Please fill out the form below. When you submit this form, you will be asked to confirm your application information. After you have confirmed your application details, if you have chosen to use a credit card, you will be redirected to our secure server to enter your credit card information.

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Membership Type
(dues year ends 12/31)
Certified Member: $140.00 - Please complete attestation below.
Sustaining Member: $175.00
Emeritus Member $35.00 - Requires FIRMA Board review and approval.
 
Full Name: *
* Please list professional designations that you would like to appear in the FIRMA Membership Directory
Preferred Name/Nickname: *
Employer: *
Title: *
Business Address: *
City: * State: * Zip: *
Phone: *
Fax:
Email Address: *
Home Address:
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Home Telephone:

Preferred Mailing Address:

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To be Completed by Applicants Requesting Certified Membership Status

Attestation:
I hereby attest that I am certified as a , such certification sponsored by . I further attest that I am in good standing through code of ethics and/or continuing education requirments with the sponsoring organization and acknowledge that I will have to meet the continuing education requirements of FIRMA.
Signature and Date

Please send a copy of your certification certificate or other evidence of certification to:
FIRMA
P O Box 507
Stockbridge, GA 30281


Payment Type: Visa/MC/Amex/Discover     Please Invoice