STEP 1 - Please enter your personal information:

Your Name - EXACTLY as you want it on your certificate: 

Company name: 

Referred by :  Select one please LIMRA ADVOCIS My Company An Associate E mail Fax Other

Mailing address:

Street: 

City:    Province:  BC AB SK MB ON QC NB PE NS NL YT   Postal code: 

Business Phone:    Ext:    Fax: 

Home or Cell Phone:    E-mail Address: 

Personal Information:

University Degree/s Held: 

License/s: 

Designations or certifications held: 

* Have you ever been convicted of a Criminal Offence for which you have not been granted a pardon?
NO    YES

* A positive answer to the above does not mean that you may not apply but be prepared for a delay in your registration while we investigate your circumstances.  

Tuition Fees

Your first-year annual EPC membership fee is waived upon successful completion of Module 4.
After completing segment 4 students must complete and pass a written examination at an authorized testing centre before receiving their EPC designation.

Please select the module you wish to do at this time  SELECT ONE Complete Program Module 1 Module 2 Module 3 Module 4

Payment

  Complete Program - (consists of all 4 modules) $1,095 + Applicable tax for your Province

  Module 1 - $295.00 + Applicable tax for your Province

  Module 2 - $295.00 + Applicable tax for your Province

  Module 3 - $295.00 + Applicable tax for your Province

  Module 4 - $295.00 + Applicable tax for your Province

Please select your desired method of payment:

For Credit Card Payment/s - We accept the following cards

Credit card information Card Type Visa Mastercard  

Card Number:  ---    Expiry Date 01 02 03 04 05 06 07 08 09 10 11 12    20 12 13 14 15 16 17  

I will Mail my Cheque        I will ICS my Cheque   

If you are paying by Cheque -
Your material will be shipped immediately upon receipt of your cheque

Make cheques payable to - CIEPS

Note - Your designation will be granted when you have successfully passed the final exam.