UT Austin CO-OP SOA/CAS Seminars Application Fall 2009

Candidate Information (Please Print Clearly Using All CAPITAL LETTERS)

First Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ MI: _ _

Last Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Mailing Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Apt # _ _ _ _ _ _ _

City: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ State: _ _  Zip: _ _ _ _ _

Phone Number ( _ _ _ ) _ _ _ - _ _ _ _

E-mail Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Student ID Number (ID card): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Academic Standing: __________________________________

Exams Passed: ______________________________________

I am registering for (mark the circle):

O Exam P/1 Seminar – Friday, Oct. 30 – Sunday, Nov. 1

O Exam FM/2 Seminar – Friday, Oct. 30 – Sunday, Nov. 1

Please note detailed times on ASC website (http://www.ma.utexas.edu/dev/asc/Seminars/)

Fee is $75 for UT students and $500 for all other attendees

Total Payment Enclosed: $ ________________

Only checks are accepted. Please make checks payable to UT Actuarial Science Club

Registration Confirmation will be sent via e-mail only. Please send an e-mail to the club’s Financial Director, Deby Thomas, at financialdirector.utasc@gmail.com if you have not received a confirmation e-mail the weekend after registration deadline.

We recommend students to bring a sweater since the room temperature tends to be colder than desired.

Refunds will not be given after the registration deadline.