Registration_Form_Cat_Mod_13 - UNISDR



|[pic] |IUA CATASTROPHE RISK MANAGEMENT CONFERENCE 2013 |

| |Friday 04th October 2013 |

| |Ludgate Room, |

| |America Square Conference Centre, |

| |Crosswall, London EC3. |

| | |

REGISTRATION : PLEASE PRINT OR TYPE. Return to deborah.finch@iua.co.uk

|NAME : | |JOB TITLE : | |

|COMPANY: | |

|ADDRESS : | |

|TOWN: | |COUNTRY: | |

|POST CODE: | |TELEPHONE: | |

|EMAIL : | |SIGNATURE : |

|Please complete one form for each attendee – We can accept one cheque or card payment for multiple delegates |

|REGISTRATION FEES: (please tick) |( |Fee |VAT @ 20% |TOTAL |

|IUA Member | |£295.00 |£59.00 |£354.00 |

|Early Bird (Non IUA Members) | |£380.00 |£76.00 |£456.00 |

|Fee applies if registered before 23 August 2013 | | | | |

|LMA Members (fee applies to registration at any time) | |£360.00 |£72.00 |£432.00 |

|General Registration (Non IUA Members) | |£425.00 |£85.00 |£510.0 |

|Fee applies if registered after 23 August 2013 | | | | |

|Members of the Organising Committee or Press | |Free of Charge |

Payments in Euros/Dollars or other accounting enquiries, contact Deborah Finch, IUA: +44 (0) 207 617 4451

PAYMENT METHOD : (please tick relevant box)

(Organising Committee Member or Press : Complimentary registration

( Invoice above delegate

( Cheque Enclosed : (made payable to International Underwriting Association Ltd)

|Payment via credit card : (we only accept MasterCard or Visa) |

|( MasterCard ( VISA |

|Card Number : |(((( (((( (((( (((( |Expiry Date : …………… |

|Name as it appears on Credit Card : ……………………………………............................................... |

|If paying by credit card, please fax/email as below. We will call you for confirmation of credit card security digits/CVV number. Terminal receipt |

|will be emailed to you immediately. |

~~~~~~~

Cancellation: If you are unable to attend, a substitute delegate is welcome at no extra charge. Alternatively, we will make a refund for cancellations received in writing no later than 06 September 2013. Thereafter we regret that no refunds can be made.

Special Requirements: We would like to accommodate the special needs of our attendees and ask you to advise us in advance of any special dietary or access requirements.

For all enquiries regarding this event including registration, designated hotel rates, sponsorship and exhibiting opportunities, please contact : Deborah Finch, IUA, Tel +44 (0) 207 617 4451,

email: deborah.finch@iua.co.uk Fax : + 44 (0) 207 617 4440

How did you hear about the event? Direct Email ( Other ( IUA Website (

Information and updates, visit : iua.co.uk

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