The Chicago Actuarial Association (2008-2009 Membership)

Membership is open to anyone who has passed at least 2 exams of the examinations of the Society of Actuaries or the Casualty Actuarial Society, or their equivalent, or any member of the American Academy of Actuaries.
Actuaries or students who wish to join the CAA (and members who wish to renew) may print this form and submit it to:
   Paul Dennee - CAA Treasurer
   Chicago Actuarial Association
   P.O. Box 81675
   Chicago, IL 60681-0675

Name       ________________________________________________

Company    _______________________________________________

Address    ________________________________________________

City, State, ZIP ___________________________________________

E-Mail Address ________________      Phone #: ___________ Ext _____       

   Are you a [ ]new  or a  [ ]current or past member?           

List Your Actuarial Affiliations:  Society of Actuaries {FSA/ASA/Student}_____
                                 Casualty Actuarial Society {FCAS/ACAS/Student}_____
                                 Conference of Consulting Actuaries {FCA/ACA/MCA} _____

Please check the following designations which apply:
Other Actuarial: EA [ ]    FCIA [ ]    FIA [  ]     MAAA [  ]    
Other Professional:  CFA [ ]  CPA [  ]   FLMI [ ]    Ph.D. [ ]    Other ________
Retired [  ]

Specialty (select one):  Casualty__     Computer__    Credit Life__     Finance__  
Generalist__   Group Life & Health__  Individual Life__  Individual Health__   
Investments__    Pension__   Other ______________

Annual dues are  $30.00. Dues are waived for retired members.

Cheques should be payable to the Chicago Actuarial Association.

We are also able to accept payment by [  ]VISA,  [   ]MasterCard,  [  ]Discover,   [ ]AmExp

Name as it appears on this credit card _________________________________

Card Billing Address, City, State, Zip _______________________________________

 

Card Number:_______________________________    Expiration Date _______

Card Security Code*  ______
*(4-digit code on front of American Express, or 3-digit code on back of  Visa, MasterCard, Discover)

Signature_________________________