REGISTRATION FORM
REGIONAL TRAINING SEMINAR
IAIS – ASSAL – SVS
18 – 21 November 2003
Please send this form to the fax number (56-2) 473 4002 or by e-mail to:
Before November 7, 2003
First Name:
Last Name:
Institution:
Title:
Address:
Phone (including country and city code) / Fax: / e-mail:
Status: / Special Events:
I will attend to?
Industry representatives, / Wednesday, November 19 – Cocktail Hotel Marriott
Observers and ASSAL Members / Yes / No / Accompanying person
US$350 / Thursday, November 20 – Dinner (formal dressing)
Yes / No / Accompanying person
IAIS government representatives / Friday, November 21 – Closing Lunch
No registration fee required / Yes / No / Accompanying person
Payment Method:
Check in US dollars / Bank transfer
In the name of the “Superintendencia de / “Client’s Transfer” MT 100, to BECH:
Valores y Seguros” / Beneficiary: Superintendencia de Valores y Seguros
US branch / Account in US dollars N° 13.764, from Banco del Estado de Chile you must
Sent it to / ask the bank that the funds be sent via New York, to the following address:
Secretaría ASSAL / Correspondent Bank: WACHOVIA BANK N.A
Av. Libertador Bernardo O´Higgins 1449 / City: New York
Piso 9 – Santiago – Chile / Country: USA
Swift: PNBPUS3NNYC N° ABA 026005092
Account number of Banco del Estado de Chile in the correspondent bank is N°2000192290247.
Swift message, field 71ª should mention “OUR”
Instructions of Payments
If you send payments by bank transfer, please indicate the complete name of the participants. Remember that the cost of the bank transfer should be assumed by the issuer.
Please, send us a copy of the bank transfer order to the fax number: (56-2) 473 4002
Cancellation of a Registration to the Seminar
All the cancellations must be sent by e-mail and/or by fax to: or (56-2) 473 4002
The refunded will be 100% if the cancellation is sent before November 7. 50% of refund will be done if notification of cancellation in given up between November 7 and day of the opening ceremony.
If a member, observer or representative can not attend it will be allowed that another delegate can participate.