Application Form

Company Name ………………………………………………………………………………

………………………………………………………………………………………………….

Contact Details………………………………………………………………………………
………………………………………………………………………………………………….

Area of business ……………………………………………………………………………..

…………………………………………………………………………………………………..
…………………………………………………………………………………………………..

Event Name …………………………………………………………………………………...

…………………………………………………………………………………………………..

Event Date

Event Description

Target Audience ………………………………………………………………………….

Size of Event
50-100
100-200
300-500
500+

Skills/Area of Event
Technical
Personal Development
Learning & Development

Which area is this applicable for

Claims
Underwriting
Insurance Broking
London Market
Mortgage Profession
Life & Pensions
Personal Finance Society
Type of support from CII
CPD Accredited
CII Contra arrangement (list of offers encl)
Mutual CPD Recognition Events
Promotion type
Web
Electronic newsletter
Print

Other details of event, e.g. website, promotion, speakers

Declaration
I confirm that I have provided the documentation to support this event / these
events meeting CPD Event Accreditation standards.
I agree that a member of the CII may attend our event to confirm that the
CPD Accreditation standards are being met.

Please return this form to CII Events (ciievents@cii.co.uk) Fax: +44 (0) 870 606 1812