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Task 4

Registration Form

Of course all submitted information is kept in strictest confidence.
You always retain control of your information with D.W.Simson & Co.
Our Service are always at no cost to you

Name:

Address:

City: State/Province:

Zip Code:

Country:

Phone: (H) Fax

Phone: (W)

(if able to speak freely)

Email:

Company Name:

(optional)

Desired Region: Other:

Professional designation earned:
College Student Acturial Student ACAS FCAS ASA
FSA EA CFA MBA MAAA FIA FCIA
FIAA Financial Engineer M.S. Ph.D. Data Mining Quant

Other Designations: