Member Details - $250/Person:
Rows
Name
Email
Member 1
Member 2
Member 3
Member 4
Member 5
"Email List Only" Names and Emails - No Cost:
Rows
Name
Email
Non-Member 1
Non-Member 2
Non-Member 3
Non-Member 4
Non-Member 5
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( X )
Membership Renewal (per person)
$250.00
$
250.00
Quantity
Credit Card Transaction Fee
$0.15
$
0.15
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Company Name
*
Company Type
*
Please Select
Claims Support Services
Consulting Services
Cruise Line
Educational Institution
Engineering & Forensics
Environmental Solutions
Financial Services
Government
Insurance Brokerage
Insurance Company
Insurance General Agent or TPA
Legal Services
Marine Surveyor
Medical Evaluation & Consulting
N/A - Retired
Private Investigation
Risk Management Solutions
Salvage and Diving Services
Seafood
Shipyard
Transportation and Logistics
Travel Agency
Other
Company Type, if "Other"
*
So PSMCA may better serve our membership while we plan future events, which of the following events would you attend? (multiple selections accepted)
Golfing/Mini Golf
Curling
Bowling
None
Other
1
Opt-Out: "I do not authorize PSMCA to share my name and/or contact information with other PSMCA members and vendors."
Submit
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