2024 Agency Member – Pay by PayPal – Ky Association of Mitigation Managers

Membership Type *

Agency/Organization $250

Up to 10 members

First Time to be a KAMM member?

Yes

No

Does your Organization Represent? *

Local

State

Federal

What is the Professional Discipline of the Agency or Organization? *

Check all the apply. Please describe the discipline if you checked Other.

Agency / Organization Name *

Address *

City *

State *

Zip Code *

Phone *

What County in Kentucky is your organization located?

Committe Interests for the Group *

Check all that apply

How Many in the Group Registration? *

How many staff are to be included in membership. 1 - 10. Complete member information below.

#1 First Name *

First name of the KAMM Member

Last Name *

Last name of the KAMM Member

Title *

KAMM Member Email Address *

#2 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

#3 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

#4 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

#5 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

#6 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

#7 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

#8 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

#9 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

#10 First Name

First name of the KAMM Member

Last Name

Last name of the KAMM Member

Title

KAMM Member Email Address

Comments

Add anything you want KAMM to know.

Payment Method - By Credit Card (PayPal) *

$250

When you hit Submit, your registration with KAMM is complete. You will automatically be linked to PayPal. To Pay by Credit Card, complete the credit card transaction information on PayPal or your credit card. When your credit card transaction is complete, you will receive a $250 receipt from your credit card (or PayPal). If you do not receive a receipt, then your credit card payment did not go through. You'll need to try again. You will receive an e-mail confirmation from KAMM that you are registered. Please check your junk/spam e- mail folder for the KAMM auto response for registration. Have questions, contact us at help@kymitigation.org.

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