ARiMI Asian Risk Management Institute

COMMON REGISTRATION PAGE FOR CPRM & ERM

You have to choose which program you wish to attend:

1 - To complete the first level CPRM & Professional Certificate Program, you need to attend all the Core Certificate Modules over a 2 months period.

2 - You can also choose to register directly for the entire comprehensive ERM & Professional Diploma Program ( CPRM & Professional Certificate is also automatically included as you will need to attend all Core Certificate Modules, all Core Diploma Modules and at least 2 groups of Elective modules over a 6 months period).

After selecting which program you want to attend, please also complete the form with all the information required for registration.

~~ERM/CPRM in 1st Quarter 2009~~ (Choice Not Available)

ERM/CPRM join Next Quarter 2009 (click here to check calendar)

~~ERM/CPRM in 3rd Quarter 2009~~ (Choice Not Available)

IMPORTANT: You have to select the Program you you wish to attend (select one only):
CPRM & Professional Certificate in Risk Management
Comprehensive ERM & Professional Diploma in Enterprise Risk Planning and Management
Exam Fee

I am a member of the National University of Singapore (NUS) Alumni
(10% discount on course fees applicable for NUS Alumni who is not sponsored by an organisation.)

Personal Information

Home Address & Contact Details

NRIC/FIN/Passport: *
First Name: *
Family Name: *
Salutation: *	Mr. Ms. Mrs. Other
Gender: *
Date of Birth: *
Highest Education: *

Mailing Address
Full Address: *
Building:
City: *
Country: *
Postal Code: *
Personal Email: *
Mobile No.: *
Home Phone: *

Business Information

Business Address & Contact Details

Title or Position: *
Division/Department:
Primary Responsibility: *
Occupation Type: *
Years of Work Experience: *
Company Name: *
Company Web Site: * http://
Number of Employees: *
Annual Sales: (in million of SGD) *

Mailing Address
Full Address: *
Building:
City: *
Country: *
Postal Code: *
Office Phone: *	Ext.:
Business Fax:
Business Email: *

Industry: *

Past Graduate
Past ARiMI course/workshop that I attended

1.	Program:
2.	Program:
	Date:

How did you hear about this programme? *
(check all that apply)

Online Search

Word of mouth, please specify:

		Employer HR, Education, or Training Dept		Manager or Supervisor
		Colleague		Friend
		Past Participant of This Programme		Past Participant of a Course/Workshop by ARiMI
		Other

NUS or NUS Extension

Newspaper or Magazine Article by Asian Risk Management Institute

Professional Association/Chamber

Conference/Workshop in which ARiMI Participated

Other

Please keep me informed about: *

	Check all the boxes
	Designation Programmes
	Conferences and Workshops
	Corporate Training & Advisory Services
	The ARiMI Newsletter - Risk Connection

Payment of Exam Fees
(NUS Extension will contact you for payment of course fees)

Cheque - Please make your cheque payable to
ASIAN RISK MANAGEMENT INSTITUTE Pte. Ltd.
and send your cheque to the following address:
Asian Risk Management Institute
9 Penang Road, Park Mall,
#12-01, Singapore 238459

Telegraphic Transfer (T/T), we will provide transfer information by email

Bill my company

Contact Person: *
Phone: *

I agree to the Asian Risk Management Institute payment terms