MLC registration form

Registration Form
for
Jim Daniel's MLC Seminar
through AbacusLI

11 - 15 March 2017
Hyatt Place - UC-Davis
Davis, CA


The fee for the seminar is $1300. Payment can be made by check to Jim Daniel (payable to Dr. James W. Daniel, ASA, and sent to Dr. James W. Daniel, 1515 Shasta Drive, #1516, Davis, CA 95616), by credit card over a secure connection (processed through PayPal, where you can choose to buy on credit), or by registering through Abacus Learning Institute. 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 e-mail it to Jim Daniel (jimdaniel@actuarialseminars.com) as soon as payment is arranged
and if possible before two weeks before the start of the seminar, although later registration is possible if room permits; no refunds after two weeks before the start of the seminar (unless the seminar is sold out, has a waiting list, and a replacement can be found from that list). Queries may be addressed to him by e-mail at 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 before the start of the seminar.

Indicate payment method: 

 
Participant's name:

Home address:

 
Home phone:

Business/employer name & address:

 

Work phone and FAX:

e-mail address:

 

Registrants must arrange their own housing.