ARiMI Asian Risk Management Institute

To complete the CPRM designation, you need to attend all Core Modules and at least one Elective Module Group.
(You can choose to attend both Elective Groups).

Please consult the programme dates to help you select the preferred class.
After selecting which class you want to attend, please select the corresponding Elective Module Group for that class.

CPRM in 1st Quarter 2008 (Choice Not Available)

CPRM in 2nd Quarter 2008 (Group AX8 - Starting 14 April 2008)

CPRM in 4th Quarter 2007 (Choice Not Available)

Core Modules 1-6
Elective Module Group 1
Elective Module Group 2
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