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iCAS Membership Application

INSTRUCTIONS: Please complete your application below by filling in the online form below. Those items marked * are required. Once you complete this application, you will receive a welcome letter via email in a few days from The CAS Institute explaining more about your membership and opportunities for you to get involved in iCAS.
1.First Name(Required.)
2.Middle Name/Initial
3.Last Name (Family Name/Surname)(Required.)
4.Address Line 1(Required.)
5.Address Line 2
6.City(Required.)
7.State/Province
8.Zip/Postal Code(Required.)
9.Country(Required.)
10.Date of Birth(Required.)
Month
Day
Please enter your birth month and day:
11.Year of Birth
12.Gender
13.Preferred Email(Required.)
14.Alternate Email
15.Preferred Phone (add country code if not +1 in North America)(Required.)
16.Alternate Phone (add country code if not +1 in North America)
17.Organization/Company(Required.)
18.Position/Title(Required.)
19.Current/recent occupation and/or job role
20.LinkedIn Profile Link
21.Your Academic Degrees - List each degree on a separate line - Degree, Major/Concentration, University/College/Institution (e.g., BA Math Temple University).(Required.)
22.Relevant Post-Graduate Academic Programs (non-degree) - Please list each program on a separate line: University/College/Institution, Type of Educational Program, Area(s) of Study, Number of Years Spent, and whether or not you completed the course/program.
23.How did you learn about The CAS Institute?(Required.)
24.Professional Designations, Credentials, Certifications (not software certifications) (select all that apply):
25.Relevant Online Courses, Bootcamps, In-depth seminars/master classes or other types of Educational Programs (describe briefly):
26.In which of the following areas do you have significant background, qualifications or work experience (check all that apply)?
27.Do you have significant interest in the Insurance Industry?(Required.)