CCIM Central District Sponsorship Application

CCIM Central District Sponsorship Application

To register as a sponsor and make a payment, please complete all of the fields below:
Name *

First Name Last Name
Company Name *
E-mail *
Work Number

Area Code Phone Number
Mobile Number

Area Code Phone Number
Sign-up for Annual, Quarterly, or Event-based sponsorship with the options below.

For 2-year sponsorships, please contact central@flccim.com

Payment: *

Diamond Sponsor $ 3,500.00

Payment Plans:

Platinum Sponsor $ 1,500.00

Payment Plans:

Gold Sponsor $ 1,000.00

Payment Plans:

Silver Sponsor $ 500.00

Payment Plans:

Billing Address *