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Membership Application

Become a member today – simply select your membership type and fill out the information below. Clicking “Join Now” will allow you to pay securely online by credit card.

Application Form

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Please choose your membership level below: *

Corporate A
Corporations or firm s with over 50 employees. - $1,500.00
Corporate B
Corporations or firm s with under 50 employees. - $825.00
Not-for-profit
Not-for-profit or professional associations or organizations. Not-for-profit Members are entitled to add three (3) name s to membership listing. - $450.00
Individuals
Individuals who are self-employed or run affiliated with a company - $175.00
Emerging Leaders
Emerging leaders in the insurance,reinsurance and allied fields who are not currently part of the membership listing of a corporate or not-for-profit IFNYMember, 30 years old or younger in entry or mid-level positions - $50.00
Promotional offer
Please enter promo code below to verify your eligibility - $25.00

Total Amount

$0.00

Promo Code

Company Information

Key Contact *

Company *

Title *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

of name functional

Phone *

Email *

Website / URL

Years in the industry

Insurance designation(s)

Date of birth (optional)

Please choose the functional areas below that best describes you or your companies primary activities:

Underwriting
Reinsurance
Accounting and Finance
Legal/Regulatory
Actuarial
Agency/Brokerage
Risk Management
Claims
Advisory
Business Development
Rating Agency
Industry Organization or Publication
Other

Additional Member Names (Include name and email)

*

I Agree to Refund Policy

*Membership cancellations received within 14 days of registration may be eligible to receive a full refund less a $50 service fee. Registration cancellations to upcoming events must be received five (5) business days prior to the event in writing by email, fax, or postal mail. Cancellations received after the stated deadlines will not be eligible for a refund. Refunds will not be available for registrants who choose not to attend an event. All refund requests must be made by the attendee or credit card holder. Refunds will be credited back to the original credit card used for payment or issued by check

Credit Card *

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Contact Us

Tel 914.966.3180, x113
Email rebecca.mclean@cinn.com

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