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CCIM Course Registration Form

Completed forms can also be printed and payment can be faxed to 312-321-4530 or mailed to CCIM Institute, 430 N Michigan Ave, Suite 800, Chicago, IL 60611. For questions, call a CCIM Customer Service Representative at 800-621-7027 or e-mail courseinfo@ccim.com.

*Required

Student Information
First Name:*
Last Name:*
Company:
Address:*
(No P.O. Boxes)
City:*
State/Province:*
Zip/Postal Code:*
Country:
Telephone:*
Fax:
E-Mail:*

Courses Information

You can see the Annual Candidacy Application here

Course ID: Course Name:

Payment Information

If you would like to enclose a check in the mail, checks are payable to CCIM Institute.

Please note: Space is limited in courses. Check payments may take up to two weeks to process.

Member Type:*
Method of Payment:*
Name of Cardholder:*
Card Number:*
Expiration Date:*
(MM/YYYY)

The CCIM Institute reserves the right to cancel or change any scheduled course at any time. Students enrolled in a course that is cancelled will be notified as far in advance as possible. Students have the option of getting a full refund or transferring into another course. Please note that the Institute is not responsible for any out-of-pocket expenses (lodging, airfare, etc.) students may incur when a course is cancelled.

(For your record, faxing or mailing)

Online: Press "Submit" button
Fax: 312-321-4530
Mail: CCIM Institute, 430 N Michigan Ave, Suite 800, Chicago, IL 60611
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