PAMIC : Underwriting & Loss Prevention Seminar

Overnight Accomodations
Hampton Inn and Suites • 749 East Chocolate Avenue • Hershey, PA
A Group Rate of $99 is available for all reservations made before October 7. To reserve your room call 717-533-8400 and ask for the PAMIC Group Rate.

CE Credits
This Seminar has been submitted to the Pennsylvania Department of Insurance for 6 CE Credits. To request credits outside of PA, please call PAMIC at 717-303-0197. Call early as credit requests must be submitted in advance.

Cancellation Policy
A full refund for this seminar will be given if a cancellation notice is received on or before October 30, 2008. Cancellations received after this date will not be eligible for a refund.

Underwriting & Loss Prevention
Seminar Registration Form

* required field

name*
nickname for badge
company
address*
city / state / zip code*	P Co de*
phone*
e-mail*
Please describe any Dietary or Accessibility Needs, if applicable:

LUNCH SELECTION (if no selection is made, chicken will be provided)

Baked Chicken Breast
Seared Sea Bass
Stuffed Portobello

CE CREDITS

I would like to receive PA CE Credits for this seminar.

License Number: (required for credit reporting)

PAYMENT

Please select from the following options:

PAMIC Member/Associate: $125
Non-Member: $200

TOTAL DUE

Please select your payment option from one of the following:

I will be sending a check to pay for my registration

Please send an invoice

Pay online using my credit card.* (Click on the Paypal button after hitting 'Submit.')

* Please note that a $5 service fee will be charged for using this service.

> Get directions to the Hershey Country Club
> Download the Registration Flyer