Membership Application Form
The Member Name and primary contact details provided below will be published in the Members section of the IMAC website www.imac.ky
Member Name
*
CIMA Licence #
*
If not applicable, please enter “N/A”
Industry
*
Website
Contact Details
FOR CAPTIVES, PLEASE COMPLETE THE INSURANCE MANAGER DETAILS AS THE PRIMARY CONTACT AND PARENT/DIRECTOR DETAILS AS SECONDARY CONTACT.
Contact Person (Primary)
*
Email Address (Primary)
*
example@example.com
Title/Role (Primary)
*
Company Name (Primary)
*
Company Address (Primary)
*
Phone (Primary)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Contact Details (if applicable)
Complete this section only if there is a secondary contact.
Contact Person (Secondary)
Email Address (Secondary)
example@example.com
Title/Role (Secondary)
Company Name (Secondary)
Company Address (Secondary)
Phone (Secondary)
Please enter a valid phone number.
Format: (000) 000-0000.
Membership Class
IMAC membership year runs to December 31st of each year and is not prorated
Select one
US$ 750 - IMAC Member – Cayman Class B, C & D Licensee
US$ 750 - IMAC Overseas Associate – Non-Cayman-Based Captive Service Providers
US$ 1,200 - IMAC Local Associate – Cayman-Based Captive Service Providers
US$ 1,800 - IMAC Full Member – Cayman Licensed Insurance Manager (<10 Captives)
US$ 3,000 - IMAC Full Member – Cayman Licensed Insurance Manager (10+ Captives)
Company Logo Upload
*
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Please upload a high-resolution, high-quality version of your company logo (PNG or JPEG)
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Communications Consent
*
By clicking the Submit Application button, I consent to being added to IMAC’s e-newsletter mailing list and receiving communications from IMAC.
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