On-line Conference Registration

Registration Form

Personal Details of Delegate (Fields marked with * are mandatory)
Full Name * (e.g. Steven Tan)
Family Name/Surname* (e.g. Tan)
Name to appear on conference badge *
Company * (e.g. Insurance Company Pte Ltd, XYZ Pte Ltd)
Industry Segment * Others (Please specify below)
Job Title / Designation*
Mailing Address *

City/State
Postal Code*
Country *
Telephone *
Fax *
E-mail *
Secretary's E-mail (if any)
Additional Information Please tick the appropriate checkbox

This is my first time attending an SIRC event.
I will require a Letter of Invitation from the Organiser for visa application purposes.
Catering Arrangements

I confirm my attendance at:
Welcome Cocktail on 30 Oct 2011
Networking Lunch on 31 Oct 2011
Networking Lunch on 1 Nov 2011

The 11th SIRC Organising Committee will cater light breakfast for registered delegates at Melati function room, Level 4, Sands Expo and Convention Center, from 7am to 9am on Oct 31 and Nov 01, 2011.

All meals served at the Conference will be prepared without pork and lard. To cater to the special dietary needs of delegates, a separate vegetarian section will be provided and all dishes containing beef will be clearly marked.

Golf Tournament I will be participating in the Golf Tournament on Wednesday, 2 Nov 2011.

Current Golf Handicap:

Home Club (if any):
Regular Fee S$1480 per Delegate 
Conference Fees
Early Registration Fee
(extended till 15 July 2011)
S$1,180
Regular Fee
(from 16 July 2011)
S$1,480
Golf Tournament Fee Per Participant S$220
Total Fees Payable
S$
Mode of Payment
By cheque/draft in Singapore dollars drawn on a Singapore bank and made payable to the "Singapore College of Insurance Limited"
By telegraphic transfer (in Singapore Currency) to :
Beneficiary: Singapore College of Insurance Limited
Bank Account No: 001-053726-1
Name of Bank: DBS Bank Ltd
Address of Bank: 6 Shenton Way, DBS Tower 2, Singapore 068809
Swift Code: DBSSSGSG

* I will undertake to indemnify the organisers for all bank charges.
Credit Card (for VISA or MasterCard only)
Cancellation / Substitution Policy

Any cancellation of registration notified in writing before 30 September 2011 will be allowed subject to payment of an administration fee of S$250. No refunds will be allowed for cancellations notified thereafter. However substitution or replacement of delegates will be allowed.

Please check and print a copy of the completed online Registration Form, if needed, before submission.

Copyright © 2011 Singapore College of Insurance Limited. All Rights Reserved by SCI.