Courier Service Request Form

Courier Service Request Form

Available for International Members Only. *Note: Courier Service does not affect the normal processing time to print, sign, affix seal, etc. for preparing the certificate for shipping.
For your convenience, Autofill will keep all your input data for 24 hours if you must leave the form before completing. You must use the same browser in order to pick up the form where you left off!
Date*

MonthDayYear
Member Name*

PrefixFirst NameMiddle NameLast Name
Mailing Address for Courier Delivery*

Street Address

P.O.Box # or Suite # (if any)

CityState / Province

Postal / Zip Code: If you are applying from a country that does not utilize postal codes or zip codes, Type “N/A” or NONE. This field is not for PO Boxes)Country
E-mail*
Phone Number for Courier*

Country CodeArea CodePhone Number
Click on the circle indicating Credit Card below, then click on Submit and you will be directed to Affinipay to make your payment. All payments to TheIIC are via Credit Card ONLY! Your form will be submitted to TheIIC and a copy will be attached to the confirmation email you will receive.
Submit and Make Payment*

Credit Card
Should be Empty: