-  
Online Sign Up & Registration
39th Annual National Premium Tax Conference
November 15-17, 2011
Reno, Nevada
 
Company Name:
Company NAIC Code:
Company NAIC Group Code:
Attendee Name:
Attendee Title:
Mailing Address (1):
Mailing Address (2):
City, State, Zip:
Attendee Telephone:
Attendee Email Address:
   
Company type (mark and "X" next to appropriate classification):
LHA = Life/Health and Annuity
PC = Property and Casualty
C = Combination
O = Other
   
How many years premium tax experience do you have?
 
Have you attended the National Premium Tax Conference before?
  No Yes
What are your suggestions for topics for this year’s agenda?
 
May we contact you about volunteering to assist with the Conference?
  No Yes
If YES, what topic are you interested in teaching?
 
Are you willing to sit on a panel?
  No Yes
Are you willing to teach a break-out session?
  No Yes
Are you willing to present a topic in the group session?
  No Yes
   
 
At this time we will begin accumulating Roundtable Questions. Please forward your questions to Jim Williams at jwilliams@massmutual.com. The Roundtable session is a forum for group discussion. The session moderators are not responsible for providing answers to the questions, but are there to facilitate the discussion.
Please make your check in the amount of $375 payable to the “National Premium Tax Conference” and mail to:

National Premium Tax Conference
c/o Jan Gillerin
90 Maynard Street
Northborough, MA 01532
Attendee cancellations subsequent to October 1, 2011 are not refundable. You may substitute another attendee from your company at any time.
We apologize for the inconvenience, however we do not accept credit cards. For the convenience of your Accounts Payable department, our TIN is 39-1852149. Payment must be received by September 15, 2011.
 
HOME | AGENDA | SIGN UP