Registration Form
for
Jim Daniel's C/4 Seminar
28 March – 1 April 2012
MAA Carriage House Conference Center
Washington, DC
The fee for the seminar is $995. Payment can be made by check to Jim Daniel (payable to Dr. James W. Daniel, ASA, sent to Dr. James W. Daniel, PMB #243, 1520 E. Covell #B5, Davis, CA 95616) or by credit card over a secure connection.
Since the seminar sometimes fills up, checks should be mailed for
next-day delivery; if an employer is paying and needs time to process
payment, I'll reserve the slot if a person with financial authority
sends me an e-mail or fax guaranteeing payment by the employer. In any
case,
please complete this registration form and submit it to Jim Daniel
by mail (to Dr. James W. Daniel, PMB #243, 1520 E. Covell #B5, Davis, CA 95616), FAX (530/297-6319) or
e-mail (jimdaniel@actuarialseminars.com) as soon as you arrange payment
and if possible at least two weeks prior to the start of the seminar session,
although later registration is possible if room permits; no refunds after two weeks prior to the start
of the seminar session. Queries may be addressed to him by mail at the above address or by e-mail to
the above address. Registration is limited; the Seminar may be canceled (with full refund) in the unlikely
event that fewer than five registration fees have been received by two weeks prior to the start of the
seminar session.
Indicate payment method:
- credit card over a secure connection (date of transaction = ?)
- check to arrive (date to arrive = ?)
- e-mail guarantee of payment coming from employer (date of guarantee = ?)
Participant's name:
Home address:
Home phone:
Business/employer name & address:
Work phone and FAX:
e-mail address: