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2013 Asia Distribution Conference - Online Registration

Renaissance Kuala Lumpur Hotel, Kuala Lumpur, Malaysia
11/20/2013 - 11/21/2013

Fill in the information below and click the Submit button at the bottom of the page. If you have any questions, please contact LIMRA Customer Service at 800-235-4672, 860-285-7789, or customer.service@limra.com.

Note: Required fields are marked with an (*).

LIMRA Members:
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All others, please fill out the form below
Attendee Information
* First Name (given name):
  
Middle Name or Initial:
* Last Name (family name):
 
Nickname:
* Business Title:
 
Professional Designation(s):
* Job Level:
 
* Functional Area:
 
* Line of Business:
 

* Responsibility :












 

* Company:
 
* Street Address:
 
Street Address Line 1:
Street Address Line 2:
* City:
 
* Country:
 
* State/Province:
 
Postal Code:
 
* Work Phone:
 
Fax Number:
* Corporate Email Address:


Registration Fees
* Primary Attendee Registration Fee (after October 22, 2013)

   
Promotional Code (if applicable)

Attendee Information
* Name for Badge:
   
* Is this your first time attending the Asia Distribution Conference?
   
* What is your job function?
   
Advanced Attendee List

LIMRA and LOMA provide an advance attendee list to this conference’s Exhibitors and Sponsors. These vendors offer unique solutions and specialized expertise for our industry; we permit them to use the list once in conjunction with this event.

(Full Privacy Policy is viewable at www.limra.com/privacypolicy.aspx.)
* May we include your e-mail address on the advance attendee listing?

   
Interpretation

This conference will be presented in English. Interpretation services will be available into languages requested by 16 or more people. The final deadline for interpretation requests is 22 October, 2013. Please request interpretation equipment by selecting from this list.





* Do you have any dietary restrictions? If so, please list them.
   

Spouse/Significant Other
A registration fee of $125 is available to spouses and significant others of registered attendees. Individuals in an industry-related position, co-workers, or associates do not qualify. We invite spouses/significant others to participate in the event's food and social functions and ask that they wear their badge to these events. Participation in the general sessions and workshops is limited to those who have paid the full registration fee to attend the conference.
* Will you be attending with a spouse/significant other?
   
Name for badge for spouse/significant other:

Cancellation Policy
All cancellations and refund requests must be received in writing. These requests carry a U.S. $100 administrative charge. Full refunds minus the administrative fee will be granted on written requests received no later than ten business days before the meeting date. No refunds will be granted if the request is received within ten business days of the meeting. If for any reason a meeting is cancelled, LIMRA/LOMA will refund the total registration fee. However, LIMRA/LOMA will not be responsible for any travel, hotel accommodations or other costs incurred. Cancellation requests should be submitted to meetings@loma.org.