ENROLLMENT FORM

To enroll: Please fully complete the enrollment form before printing, obtain the necessary participant and authorizing signatures, and fax or mail the form to AIF. We advise you to call the Institute in advance to check availability on the program of your choice.

PROGRAM
1.	Name of program(s):

2.	Date of program(s):


PERSONAL DETAILS
3.	Last name:		Gender:
4.	First name:		Middle initials:
5.	CFA Institute Member ID number: (If you are claiming CFA Continuing Education Credits)

COMPANY DETAILS
6.	Company name:
	Nature of business:
7.	Current job title:
	Department/Location code:
8.	Postal address:
	Postal code, city:
	Country:
9.	Street address:
	Postal code, city:
	Country:
10.	Office phone:
	Mobile phone:
	Fax number:
	E-mail:	Please fill in your e-mail address in company details before printing the form

	Please replace address details if different from the ones stated below:
11.	Address invoice to:	Name:	Dept./loc.code
	Postal address:
	Postal code, city:
	Country:
12.	Company training officer:	Name:
	Postal address:
	Postal code, city:
	Country:
13.	Person you report to:	Name:
		Job title:
	Postal address:
	Postal code, city:
	Country:
	Office phone:
	Email:

PRIVATE DETAILS
14.	Private address:
	Postal code, city:
	Country:
15.	Private phone:
16.	Date of birth:


EDUCATIONAL BACKGROUND
17.	Subject of degree	Name of school/university	From	Until	Diploma



	Other relevant programs attended (including AIF programs):


WORK EXPERIENCE
18.	Company	Department	Job title	From	Until

19.	Please give a brief description of your current job, concerning your tasks, responsibilities and number of employees managed by you directly.


20.	What are the main challenges you face in your responsibility?
21.	What do you want to learn from this program?
22.	In what way will you contribute to this program?
23.	Where did you find out about this program?
	AIF brochure	Other advertisement (specify)
	AIF website	Other website (specify)
	From my company/colleague	Recommended by
	Het Financieele Dagblad	Other (specify)
	The Economist advertisement

SIGNATURES

Please read before signing:

Completing and signing this form signifies that the participant and authorizing person are in agreement with the admission and cancellation policies of AIF.
All information on this form will be handled confidentially and will be used exclusively by AIF.
Admission will only be approved based upon a fully completed, signed and authorized enrollment form.

Cancellation Policy:
Cancellation charges / refunds are as follows:
- At least 21 days notice: € 200 administrative fee
- 20 to 10 days notice: 50% of the program fee
- Less than 10 days notice: 100% of the program fee.
Cancellations must be submitted in writing.
Postponing your enrollment to a later date is not possible.

24.

Authorizing person:

Name:

Job title:

Company

Address:

Office phone:

E-mail:

Authorizing signature:

25. Signature of participant:	Date of enrollment:

Please mail or fax your fully completed and signed enrollment form to: Amsterdam Institute of Finance P.O. Box 59536 1040 LA Amsterdam The Netherlands Tel: +31 (0)20 520 0160 Fax:+31 (0)20 520 0161
Please fill in your e-mail address in company details (10) before printing the form