Title* ---MrMrsMissMsDr

First names(s)*

Last name*

Company*

Job Title*

Address*

Post/Zip Code*

Country*

Email*

Telephone*

Nature of Business*

Type of Registration ---Broking & Underwriting Companies Book by end of April £1000Service Providers to the Insurance Industry Book by end of April £1600
**20% Vat to be added to all fees.

How would you like to pay?*

 Please call me to take my credit card details Send me an invoice via email

Billing Address (Please complete if your billing address is different to the one above)

Address

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Promo code

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From time to time we may wish to send you information and offers about Insurance Day products and services. If you do not wish to receive this information, please tick the following box. 

In some circumstances we may wish to pass on your details to carefully selected 3rd parties, in order for them to send you relevant information and offers. If you would like us to pass on your details in this way, please tick the following box. 

DATA PROTECTION: Personal Data supplied is subject to the Data Protection Act 1998. The personal information shown on this form, and/or provided by you, will be held on a database and may be shared with companies in the Informa Group in the UK and internationally.

It may be used to keep you, or any additional names provided by you, up to date with developments in your industry. If you have any questions about Informa's use of your data please write to the Database Manager, PO Box 461, West Byfleet, KT14 9BN.

Tel: +44 (0)20 7017 5239 Fax: +44 (0) 20 7017 6241 or email updatemydetails@informa.com