IBABC - CCIB Registration

	General Information

	First Name
	Last Name
	Tel. Bus.
	Tel. Res.
	Fax Number
	Email
	Brokerage

	Business Address

	Street
	City
	Province
	Postal Code

	Home Address

	Street
	City
	Province
	Postal Code

	My firm is a member in good standing of the Insurance Brokers Association of B.C. Yes No

	Is this the first time you have enrolled for a CAIB course? Yes No If No, please provide the year and province. Year Province

	Please register me for the:

	Essay Questionnaire
	Short Answer Questionnaire
	Oral Exam

	Completion of the CAIB or AIIC/FIIC programs is recommended before attempting the CCIB examinations.

	I am a graduate of the CAIB or AIIC/FIIC program.

	If successful in the examinations, and if elected by the IBAC Board of Directors to be awarded the designation of "Canadian Certified Insurance Broker," I hereby certify that I meet the prescribed qualifications, that I am an employee of a member property and casualty insurance brokerage and that I agree to abide by such other requirements as outlined in the Terms of Reference (contact IBABC for details) and as may be established by the Insurance Brokers Association of Canada and the Insurance Brokers Association of B.C. from time to time as they see fit.

	Yes
	No





Fundamentals of Insurance CAIB Program CCIB Program CPIB Program Continuing Education Seminars Video Tape Seminars Home Click here to view the September 10, 2008 CAIB exam marks and summary Consent Form for Disclosure of Information Regarding IBABC Course Participation CAIB Awards