Please Fax or Email your Registration Form to GIA. RESPONDING TO A RISKIER ENVIRONMENT Insights on Risk Management Practices 22 JANUARY 2010, FRIDAY 2PM TO 5.30PM Capital Tower, Level 9, FTSE ROOM, Singapore 068912 REGISTRATION FORM To register, simply complete all sections of this form and return it to: General Insurance Association of Singapore 112 Robinson Road, #05-03 HB Robinson, Singapore 068902 Tel: +65 6221 8788 Fax: +65 6227 2051 E-Mail: hockyew.yeo@.gia.org.sg Name NRIC/Passport No. Gender Mr. Ms. Designation Department Email Address Company Tel (Office) Tel (Mobile) Address Would you like to be updated about future GIA technical knowledge seminars? Yes, please include me for future GIA technical knowledge seminar No, please do not include me for any future correspondence Please Fax or Email your Registration Form to GIA. Closing Date: 15 Jan 2010, Friday