MAIPP Registration

This is page 1 of 5. Please complete all 5 pages to successfully register. Fields marked with an * are required.

CONTACT INFO

First Name

Last Name

Desired Name for Nametag

Business Name

Business Mailing Address

City

State / Province

Country

Zip/Postal Code

Email Address

Business Phone

Please include your area code

Home Phone

Please include your area code

Mobile / Cell Phone

Please include your area code

Business Fax

Please include your area code

PPA Number

(no number, no merits)

Member of PPA Affiliate Organization?

Yes No

Name of PPA Affiliate Organization

PERSONAL INFO

Years in Photography

Part Time: Full Time:

Have you attended MAIPP before?

Yes No

Are you attending on a scholarship?

Yes No

If yes, from whom did you receive your scholarship?

Would you like to work a few hours for the alumni association while at school?

Yes No

Emergency Contact Name

Emergency Contact Phone Number

Please include your area code

Emergency Contact Relationship

This is page 1 of 5. You must complete all steps in order for your registration to be processed. Please click continue.