ARiMI Asian Risk Management Institute

I want to register for the following exam(s) *

ARM54 Risk Assessment

ARM55 Risk Control

ARM56 Risk Financing

I want to take the exam within the following exam window:

15 January - 15 March 2008

15 April - 15 June 2008

15 July - 15 September 2008

15 October - 15 December 2008

My preferred exam date: *	/
My alternative exam date: *	/

Personal Information

Home Address & Contact Details

NRIC No.: *
First Name: *
Family Name: *
Salutation: *	Mr. Ms. Mrs. Other
Gender: *
Date of Birth: *
Highest Education: *

Mailing Address
Street: *
Building:
City: *
Country: *
Postal Code: *
Personal Email: *
Mobile No.: *
Home Phone: *

Business Information

Business Address & Contact Details

Title or Position: *
Division/Department:
Primary Responsibility: *
Occupation Type: *
Years of Work Experience: *
Company Name: *
Company Web Site: * http://
Number of Employees: *
Annual Sales: (in million of SGD) *

Mailing Address
Street: *
Building:
City: *
Country: *
Postal Code: *
Office Phone: *	Ext.:
Business Fax: *
Business Email: *

Industry: *

If you are in the insurance industry, which year did you enter the insurance business?

Past Graduate
Past ARiMI course/workshop that I attended

1.	Program:
2.	Information:
	Date:

How did you hear about this programme? *
(check all that apply)

Online Search

Word of mouth, please specify:

		Employer HR, Education, or Training Dept		Manager or Supervisor
		Colleague		Friend
		Past Participant of This Programme		Past Participant of a Course/Workshop by ARiMI
		Other

NUS or NUS Extension

Newspaper or Magazine Article by Asian Risk Management Institute

Professional Association/Chamber

Conference/Workshop in which ARiMI Participated

Other

Please keep me informed about: *

	Check all the boxes
	Designation Programmes
	Conferences and Workshops
	Corporate Training & Advisory Services
	The ARiMI Newsletter - Risk Connection

Payment of SGD 365 by:

Cheque - Please make your cheque payable to
ASIAN RISK MANAGEMENT INSTITUTE Pte. Ltd.
and send your cheque to the following address:
Asian Risk Management Institute
9 Penang Road, Park mall,
#12-01, Singapore 238459

Telegraphic Transfer (T/T), we will provide transfer information by email

Bill my company

Contact Person: *
Phone: *

I agree to the Asian Risk Management Institute payment terms