40th ARC 2005ITAM
 
 

Registration Form

40th Actuarial Research Conference
Instituto Tecnológico Autónomo de México
ITAM
August 11-13, 2005
Mexico City, Mexico

This is an online registration form. Once you have completed the registration process the system will generate a pdf form with all your payment data information. Please print, sign and send the pdf form by fax to +52 (55) 5628-4115
(Attn. ARC 2005) so we can process your payment.

You will need Acrobat Reader in order to print this document.

1. Identification

Full name:
Name for Badge:
Employer:
Address:
City:
State/Province:
Country:
Postal Code:
Day phone
(incl. area code):
Fax:
E-mail address:
Any health or dietary requirements:
Dormitory-like accomodation:
  CIESS   ROOM

2. Registration fees (in Mexican pesos, MXN$, prices include taxes)*

Number of people
Price
Cost
Late Registration (after 17/06/05)
MXN$ 1750
Additional tickets for reception on Thursday
MXN$ 282
Additional tickets for banquet on Friday
MXN$ 507
Subtotal A MXN$

*Registration fees. All prices are in Mexican pesos (MXN$). Exchange rates as of March 2, 2005 are as follows: 1 MXN$ = 0.0901 USD$ = 0.1117 CAD. For daily rates and other currencies, see for example www.xe.com

The conference registration fee will cover the costs of:

  • Continental breakfasts (Thursday, Friday and Saturday)
  • Lunches (Thursday, Friday and Saturday)
  • Reception (Thursday)
  • Gala dinner (Friday)
  • Refreshment breaks

If you are paying for more than one participant, state for each participant:

Full name:
Name for Badge:
Any health or dietary requirements:
Dormitory-like accomodation:
  CIESS   ROOM

Full name:
Name for Badge:
Any health or dietary requirements:
Dormitory-like accomodation:
  CIESS   ROOM

Full name:
Name for Badge:
Any health or dietary requirements:
Dormitory-like accomodation:
  CIESS   ROOM

Full name:
Name for Badge:
Any health or dietary requirements:
Dormitory-like accomodation:
  CIESS   ROOM

3. Dormitory-like accommodations

Must be booked for 4 nights (Wed-Sat)

Arrival date: 10/08/2005 Departure date: 14/08/2005

Number of people
Total 4 nights
Cost
CIESS
MXN$ 1280
ROOMS
MXN$ 1000
Subtotal B MXN$
Total (A+B) MXN$

4. Payment information

Important: Your credit card information will not be stored in our database (will be used only as a reference)

Credit card
Visa/Master Card American Express
Credit card number:
Security code**
(AmEx only):
Billing name:
Name on credit card:
Expiration date:
Month: Year:
Amount charged: MXN$

**The security code are the four numbers printed on the card above the engraved number

 

If you have any problems sending the fax to +52 (55) 5628-4115, please send an e-mail to lourdesg@itam.mx or ptorres@itam.mx

Cancelations and refunds

All refunds must be requested by July 8, 2005. Your conference fees, minus MXN$ 282 for processing and fixed costs, will be returned. No refunds will be made after July 8, 2005. To give notice of cancellation contact ARC 2005 Organizing Committee by e-mail arc2005@itam.mx or by fax +52 55 56284086. Registrants unable to attend the conference may send
a substitute.