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Please complete the questions below to sign-up to attend 1 of 2 upcoming CHIAP Exam Discussion Groups.

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* 1. First and Last Name:

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* 2. Email Address:

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* 3. Phone Number:

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* 4. Organization:

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* 5. Job Title:

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* 6. Are you an AHIA Member?

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* 7. Which CHIAP Exam Discussion Group would you like to attend?

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* 8. Will this be your first time taking the CHIAP Exam?

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* 9. Do you have any comments or requests?

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