Individual Membership Application

1 Start 2 Payment 3 Complete

Welcome
This is an application for individual membership. If you are seeking an MMP or CAMP Certification for the first time please use one of these forms accessible from this page instead. Membership and Certification

Welcome

This is an application for individual membership.

If you are seeking an MMP or CAMP Certification for the first time please use one of these forms accessible from this page instead.

Contact

First Name *

Last Name *

Email *

Employer

Employer we have on file for you

Is your employer info correct? *

Yes

Please add / update my employer info as follows *

Job Title *

Address

Note: You can also view and update your address information under "My PEMAC Profile Info" in the top left of the screen when you are logged in

Address *

City *

Postal Code *

Country *

State/Province *

Phone Number *

Source

How did you hear about PEMAC *

Please specify

Membership Term *

1 year prorated - expiring August 31, 2024

Discount *

n/a

Full Time University Student

Employee of Corporate or Allied Member (select from list below)

I confirm that I am employed by this Corporate / Allied Member: *

Remainder Current Year

Amount for Full Years

Total (before tax)

Online Member Directory

Please include me on the Directory

Please remove me from the Directory

PEMAC Code of Ethics Sign Off *

I agree to comply with the PEMAC Code of Ethics.

Office Use:

Number of 1 year memberships

Number of three year memberships

Membership Fee Amount