IAC Home | The Insurance Association of the Caribbean Inc.



|(Please type or print) |Registration Details |

|Title Sex M F |Please indicate membership status: |

| | |

|            |IAC Member |

|Last or Family Name First and other Names |Early Registration Fee by April 8, 2020 US |

| |$675.00 |

|            | |

|Business Title Professional Designation |Registration Fee April 9 – May 20, 2020: US$725.00|

| | |

|      |Late Registration Fee After May 20, 2020: |

|Organisation |US$825.00 |

| | |

|      |Spouse/Guest US$150.00 |

|Street Address | |

|      |LIMRA/LOMA Member |

|City |Early Registration Fee by April 8, 2020 US |

| |$675.00 |

|                  | |

|State Zip Code Country |Registration Fee April 9 – May 20, 2020: US$725.00|

|            | |

|Business Phone Fax Number |Late Registration Fee After May 20, 2020: |

| |US$825.00 |

|Email Address      | |

| |Spouse/Guest US$150.00 |

|Spouse/Guest(s)       | |

| |IAC and LIMRA/LOMA Member |

|(Dr/Mr/Mrs/Ms) Email       |Early Registration Fee by April 8, 2020 US |

| |$675.00 |

|Sex M F | |

| |Registration Fee April 9 – May 20, 2020: US$725.00|

|Company Type: | |

|Life |Late Registration Fee After May 20, 2020: |

|Non-life |US$825.00 |

|Composite | |

|Broker |Spouse/Guest US$150.00 |

|Agent | |

|Reinsurer |NON Member |

|Other |Early Registration Fee by April 8, 2020 US |

| |$995.00 |

|No of Conferences attended: | |

|None: 1-5 6-10 11-15 15+ |Registration Fee April 9 – May 20, 2020: |

| |US$1045.00 |

| | |

| |Late Registration Fee After May 20, 2020: |

| |US$1145.00 |

|REMITTANCE DETAILS | |

|(Kindly provide confirmation of transaction for payment by Cheques, Bank Drafts and Wire Transfers) |Spouse/Guest: US$150.00 |

| | |

|Wire Transfer Details: |Special Interest |

| |Exhibitors and Regulators |

| | |

|CIBC First Caribbean Grenada |Early Registration Fee by April 8, 2020 US |

| |$500.00 |

|Correspondent Bank: Wells Fargo Bank, New York, USA | |

| |Registration Fee April 9 – May 20, 2020: US$550.00|

|Swift Code/ABA Code: PNBPUS3NNYC/026005092 | |

| |Late Registration Fee After May 20, 2020: |

|Beneficiary Name: Insurance Association of the Caribbean |US$650.00 |

| | |

|Beneficiary Bank and Address: CIBC FirstCaribbean International Bank (Barbados) Limited |Please indicate if you will be participating in the |

|Church Street, St. George’s, Grenada |following activities: |

| | |

|Swift Code: FCIBGDGD |CIC Special Events |

| |CIC Opening Ceremony and Cocktail Reception (Sunday May|

|Beneficiary Account No. 107040770 |31, 2020 |

| |CIC Party (Tuesday June 2, 2020) |

| | |

|………………………………………….. |Cancellation Policy: |

|Signature of Registrant |Any cancellation for registration will be refunded less|

| |US$100.00 if received on or before April 30, 2020. Any|

|Conference Hotel – Atlantis Hotel, Paradise Island, Bahamas |cancellations received after April 30, 2020, will NOT |

| |be refunded any part of the registration fee. |

|Please note that the IAC is not responsible for making hotel bookings. | |

| |All cheques should be in US dollars, drawn on a US bank|

|Please indicate any dietary needs or preferences: |and payable to : |

| | |

|…………………………………………………………………………............. |Insurance Association of the Caribbean Inc, Thomas |

| |Peirce Building, Collymore Rock, St Michael Barbados, |

|…………………………………………………………………………………. |West Indies |

| | |

| |Tel: (246) 427-5608 Fax: (246) 427-7277 |

|Arrival Date:       | |

|Arrival Time:       |E-mail: conference@iac- |

| | |

|Departure Date:       | |

|Departure Time:       | |

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|(Please fill out these details to aid us in making your hotel check in process a pleasant one) | |

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