REGISTRATION FORM


ReBasics: Demystifying Reinsurance Allerton Hotel, Chicago, IL, May 14-16, 2012


Mr./Ms. (Name) ____________________________________ Nickname for Badge___________________________________ Title


Organization Street


____________________________________ ____________________________________ ____________________________________


City __________________ State __________ Zip ___________ E-mail ________________________ Country ____________ Phone ____________________ Fax __________________


After attending, I wish to receive continuing education credits for: [ ] CPE [ ] CPD [ ] CLE in the state of ________________.


Enclosed is payment for: _______ $1200 Early bird registration discount by 4/2/12 _______ $1250 Registration _______ $1150 RAA Association Partners _______ $ 1100 RAA Members _______ $ 750 Regulators


Payment method:


Check or money order enclosed/payable to the Reinsurance Association of America. Payment must accompany registration form and be in US dollars only.


Credit Card (circle one): Master Card VISA AMEX


Credit card number: ___________________________________ (Please list all digits from your credit card)


Expiration Date: _________________________________


Name on Credit Card: _________________________________ Authorized Signature: _________________________________ Mail form to:


Reinsurance Association of America 1445 New York Avenue, NW, 7th Floor Washington, DC, 20005


or Fax: 202.638.0936 Re Ed


Re Ed


“A great introduction to reinsurance.” Reid Edwards RMS


REGISTRATION: The registration fee includes program materials, breakfasts, breaks and lunches, and reception on Monday.


Register online at www.reinsurance.org. or


Complete the registration form and send with payment to Reinsurance Association of America, 1445 New York Avenue, NW, 7th Floor, Washington, DC, 20004 -1701, fax to 202-638-0936, or e-mail meetings@reinsurance.org.


You must be pre-registered. There will be no on-site registration.


LODGING: The Allerton Hotel has a special attendee rate of $159 per night. The hotel is located at 701 North Michigan Avenue, Chicago. Please make your hotel reservation by contacting the Allerton at 312-440-1500 – ask for the RAA Re Basics Seminar room block (expires April 17, 2012).


Cancellation Policy: All seminar cancellations must be in writing to RAA (address above), or fax to 202-638-0936. Upon receipt of your written cancellation, refunds will be issued accordingly. Through April 23, 2012 – full refund. After April 23, 2013 – no refund. Substitutes are welcome.


For more information e-mail meetings@reinsurance. org or call 202-783-8385.


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