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2. Please note that we are no longer selling plaques. If you wish to purchase a plaque from Amazon please use the link below.

   Walnut Grove Slide-in Certificate Plaque and Document Holder 

4. Please select your membership type.*
   -- Select One --Full MemberAdditional Full MemberRetired MemberAssociate Member - DOES NOT QUALIFY

   PLEASE READ:

   Associate Members do not qualify for designations. If you feel your position should qualify, please contact the membership department to review your membership status. You may only apply once your status has been updated to Full or Additional Full Member.

6. I am applying for admission Into:*
   -- Select One --CMC Certificaton ProgramMMC Certificaton ProgramEPP Program
8. Name
   I am paying for:
9. I am paying for:
   -- Select One --CMC Admission - 50.00Entire CMC Certification - 125.00MMC Admission - 50.00Entire MMC Certification - 400.00
10. Quantity
11. Shipping Cost
13. Taxable
15. Member ID Number*
    If you do not know your member ID number please contact us at (909)944-4162 and a staff member can assist you.
17. First Name*
18. Last Name*
20. Job Title*
21. Municipality/Government Unit*
23. Mailing Address*
25. Shipping Address*
27. City*
28. State/Province*
29. Zip/Postal Code*
31. Work Phone*
32. Email Address*
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