Registration Form Fall 2017

For On-line reservations: Omni William Penn Hotel (Government registrants click here)

For Phone Reservations: 1-800-THE-OMNI 1-800–THE-OMNI and reference the Insurance Consumer Affairs Exchange (ICAE).

Note: There is a cancellation penalty equal to one-night room plus tax if reservations are not cancelled 72 hours prior to the day of your scheduled arrival. Hotel Reservation Deadline is September 1, 2017.

Visit the Omni William Penn Hotel site for additional hotel information.

NOTE: A limited number of rooms are available at our block rates, so make your reservations early.


Registration Type
Register by September 1, 2017
Register after September 1, 2017
Registration fee covers the Sunday reception, Monday continental breakfast and lunch, and Tuesday continental breakfast, lunch and evening dinner event and Wednesday breakfast for the attendee. If you are bringing an ADULT GUEST, please add the following fees.
Evening Reception, Sunday, September 24: $15 Adult Guest Fee
Evening Reception, Monday, September 25: $25 Adult Guest Fee
Evening Dinner, Tuesday, September 26: $125 Adult Guest Fee
*Because we are obligated to honor our agreement for our Tuesday evening event, all guest fees are due no later than 9/5/2017. Please note: We will be unable to refund guest fees for cancellations received after that date.
Registration Information
* required information
Membership Status:
First Name *:
Last Name *:
Name on Badge *:
Title:
Company/Organization *:
Address *:
City *:
State *:
Zip *:
Phone Number *:
Cell Number:
Email *:
Adult Guest Full Name:
Adult Guest First Name:
Registration Details
Do you plan to attend for IRES CE credit?
Is this your first ICAE conference?
If no, when (or where) did you last attend an ICAE conference?
Please check the events you plan to attend during the conference.
Sunday evening reception
Monday continental breakfast
Monday lunch
Monday evening reception
Tuesday continental breakfast
Tuesday lunch
Tuesday evening dinner
Wednesday breakfast
Please note if you have any special dietary needs for your lunch and dinner:
Which Breakout will you be attending?
P&C
Life/health
NOTE: $250 ICAE cancellation fee will apply to cancellations after September 10, 2017.

Contact Richard McGee (rmcgee@icae.com) or 847.991.8454 with any special needs or questions prior to the conference.
Complete the online registration form. If an email address was provided, an email confirmation will be delivered to that address. If you don't receive the email confirmation after hitting the SUBMIT button, please contact Richard McGee (rmcgee@icae.com) for a copy. Send payment (payment by check only) along with confirmation or copy of registration form to:

Insurance Consumer Affairs Exchange
P.O. Box 892
New Hyde Park, N. Y. 11040


Registration Amount: $0
ICAE is a 501 C6 nonprofit organization
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Registration Successful!

Thank you for registering for Registration Form Fall 2017. You will receive a confirmation email shortly.

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