ACISP - Africa College of Insurance and Social Protection

AFRICA COLLEGE OF INSURANCE AND SOCIAL PROTECTION
(ACISP)

"The Bridge between Industry and Academia"

Registration No: REG/BTP/133P

Thank you for choosing to attend the INSURANCE AND PENSION REGULATORS RETREAT FOR AFRICA 2024. ACISP wants to make the process as easy as possible.

You will need to complete a separate registration form for each individual attending.

Title :

Prof.

Dr.

Mr.

Mrs.

Ms.

Miss.

Gender :

Male

Female

Surname

First name(s)

Training Title

Start Date

End Date

Country of Residence

Physical Address

Mobile :

Who will be responsible for Payment?

Employer

Employer and Self

Self

Company Name

Special dietary requirements:

None

Vegetarian

Halaal

Diabetic

Other

FEE STRUCTURE

Description	Mode	Fee(USD)
TRAINING - Fee Per Person (Distribution training session from the 27th to the 30th May 2024)	In Person	USD 500 ($) or TZS 1,400,000/=

Training and Conference Fees should be deposited to: CRDB BANK

A/c Name – AFRICA COLLEGE OF INSURANCE AND SOCIAL PROTECTION LTD
A/c No: 0250481024400(USD) at any CRDB branch.
A/c No: 0150481024400(Tshs) at any CRDB branch.

All cheques should be addressed to : Africa College of Insurance and Social Protection Ltd.
Submit the original pay-in slip to ACISP Training Facility at Masaki-Oysterbay, 386 Toure Drive, No.99.

APPLICATION FORM

FEE STRUCTURE

Training and Conference Fees should be deposited to: CRDB BANK