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

* 2. Middle Name/Initial

* 3. Last Name (Family Name/Surname)

* 4. Address Line 1

* 5. Address Line 2

* 6. City

* 8. Zip/Postal Code

* 13. Preferred Email

* 14. Alternate Email

* 15. Preferred Phone (add country code if not +1 in North America)

* 16. Alternate Phone (add country code if not +1 in North America)

* 17. Organization/Company

* 18. Position/Title

* 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).

* 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. Professional Designations, Credentials, Certifications (not software certifications) (select all that apply):

* 24. Relevant Online Courses, Bootcamps, In-depth seminars/master classes or other types of Educational Programs (describe briefly):

* 25. In which of the following areas do you have significant background, qualifications or work experience (check all that apply)?

* 26. Do you have significant interest in the Insurance Industry?

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