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Meeting Registration Form REGISTER BY August 27, 2008: ICAE Member Regulator Nonmember $875 $675 $1,175 REGISTER AFTER August 27, 2008: ICAE Member Regulator Nonmember $975 $775 $1,275 Registration fee covers the Sunday reception, Monday breakfast and lunch, and Tuesday 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 28 $35 Adult Guest Fee Evening Dinner, Tuesday, September 30 $100 Adult Guest Fee *Because we are obligated to honor our agreement for our Tuesday evening event, all guest fees are due no later than 9/20/2008. Please note:  we will be unable to refund guest fees for cancellations received after 9/23/2008. TOTAL REGISTRATION FEES: Make your reservations for the Williamsburg Lodge on-line at:  https://resweb.passkey.com/Resweb.do?mode= welcome_ei_new&eventID=62068 or by calling Williamsburg Lodge direct at 1-800-261-9530 Hotel Reservation Deadline is August 27, 2008. Remember rooms at conference rates are limited.  Rates are $195.00 per night for organization attendees under the “ICAE organization block” and government rates of $120.00 per night for our regulator attendees under the “ICAE government block”. Be sure to use the appropriate “ICAE” room block when making your reservation on-line or by phone.  NOTE:  The Williamsburg Lodge will charge your credit card four days prior to your arrival date for one-night stay plus applicable tax.  You must cancel your reservation with the Williamsburg Lodge 72 hours prior to your scheduled arrival or the Williamsburg Lodge will charge you the one-night stay, plus applicable tax. *The number of regulator rooms are limited so we recommend you reserve rooms early to obtain this special rate.  Once the government room block at the Williamsburg Lodge is full, there may be rooms available at the government room rate at the Williamsburg Woodlands facility which is a short walk from the Lodge. For additional information regarding the Williamsburg Lodge visit their web site at:  http://www.colonialwilliamsburgmeetings.com/accommodations/ williamsburgLodge.cfm Membership Status ICAE Member Regulator Nonmember Name Name for badge Title Organization Address City State Zip Work Phone Fax Number E-mail Adult Guest Name Adult Guest Badge Name Your Information If a REGULATOR: Do you plan to attend for IRES CE credit? Yes No Arrival Date/Time Departure Date/Time Is this your FIRST ICAE conference? Yes No 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 Tuesday continental breakfast Tuesday lunch Tuesday evening dinner Wednesday breakfast OTHER USEFUL INFORMATION Which Breakout will you be attending? P&C Life/Health ICAE "Breakout" sessions continually receive high evaluations. In order to use our limited time efficiently, please check any subjects you would like to see discussed during the Breakouts. Also, list any suggestions in the OTHER space. Consumer Fraud Underwriting Practices Insurance Agent Ethics Privacy Issues Customer Loyalty Use of the Internet Best Practices Technology Issues Complaint Trending/Tracking Insurance Department Audits OTHER (list below) NOTE: $150 ICAE cancellation fee will apply to cancellations after September 19, 2008. Contact Nancy Brebner (nbrebner@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 on the registration form, a copy of the form will be emailed to you. If no email address is provided, then PRINT a copy and return with payment to: Insurance Consumer Affairs Exchange P.O. Box 746 Lake Zurich, IL 60047 REMEMBER to print before you submit and then mail the registration fees along with a copy of the Exchange registration form to the above address. • ICAE is a 501 C6 nonprofit organization Federal Identification Number: 37-1148101

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