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APPLICATION
(Please
Print or Type)
New date, July 2012
Prepayment, please, to STRAIN PUBLISHING INC.,
choosing one of these options:
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1) Send
STRAIN PUBLISHING your course application with a check drawn on a U.S.
bank; or
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2) Send
STRAIN PUBLISHING your course application with an International Money
Order.
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Smoking
Preference
q
Smoking
q
Non Smoking
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HOTEL
RESERVATIONS:
On receipt of this application, a single room will be reserved
for you at the DoubleTree Fort Lee Hotel (at the
George Washington Bridge), 2117 Route 4 East, Fort Lee, New Jersey 07024 (Phone: 201 461 9000;
FAX: 201 585 9807) for Tuesday evening through Friday breakfast, July 17 –
19, 2012. Telephone Strain Publishing if your needs differ.
New date, July 2012
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Reinsurance and Contract Wording
Textbook Training Course
The
Fortieth Course
July 18 – 20, 2012
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Name
E-mail:
Work Title
Telephone:
Company
Street Address
with number
for suite, room, or floor, please.
City, State, Zip
For Your Name Tag
Name
Company
Supervisor’s Name
Telephone: E-mail:
Person to notify in emergency
Name
Telephone
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AGREEMENT:
I attach a check for $2,995* in U.S. funds
cashable by a U.S. bank (or a bank transfer in that amount) in payment for
the Course Fee. (An application must be accompanied by payment, please.)
I understand that if my
application is cancelled for any reason, I shall be entitled to a refund of
the Fee according to the following schedule, after deducting for books
shipped to me: for notice of cancellation prior to July 1, 75% refund; or
prior to July 12, 50%. No refund will be expected if I fail to appear at the
Course without notice of cancellation prior to July 12. In lieu of refund,
request for postponement to the next Course date without charge will be honored
if the request is received before July 5.
Tape recordings not permitted.
Signature___________________________________________________
Date_____________
Years
of reinsurance experience, please_____
* Deduct $200 per book if Reinsurance or Reinsurance
Contract Wording is not needed, and $300 if lodging is not needed.
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