Certified Insurance Counselor 2018

1 Date Institute/Seminar Location CityJanuary Personal DoubleTree by Hilton GR Grand RapidsMarch Graduate McCamly Plaza Battle CreekMarch Commercial Courtyard Detroit Agency Crowne Plaza LansingMay Personal Somerset TroyMay Graduate Soaring Eagle Casino & Mt. PleasantJune Life & Plaza Graduate Shanty Creek Commercial Crowne Plaza Ann Arbor Marriott Agency DoubleTree by Hilton GR Grand RapidsNovember Soaring Eagle Casino & Mt.

2 PleasantDecember Commercial Crowne Plaza LansingTo register, go online to : 7:30 Class Begins : 8:00 ReservationsContact hotel directly unless indicated below. MAIA Hotel Group Ratesavailable up to one month priorto classes. Group Code for allhotels is in your email confirmation. Battle Creek McCamly Plaza Hotel50 Capital Ave SW (269) 963-7050 Bellaire Shanty Creek Resort5780 Shantty Creek Road (231) 533-8621 Detroit Courtyard by Mariott Detroit Downtown333 E Jefferson Ave (313)

3 222-7700 Grand Rapids DoubleTree by Hilton Grand Rapids Airport 4747 28th Street SE (616) 957-0100 Lansing Crowne Plaza West925 S. Creyts Road (517) 323-7100 Mt. Pleasant Soaring Eagle Casino & Resort6800 Soaring Eagle Blvd. (989) 775-7777 Troy Somerset Inn2601 West Big Beaver Road(248) 643-7800 Ypsilanti Ann Arbor Marriott Ypsilanti at Eagle Crest1275 S.

4 Huron Street (877) 757-7133 Cancellation Policy: If you must cancel your registration, you will receive a refund minus 25% of the registration fee. No refunds will be given to those who attend part of a program, or who are no-shows. If you do not cancel and do not attend the program, you will be considered a no show and no money will be refunded, nor will your money be transferred to a different : The CIC Graduate Seminar cancellations received within 7 days of the seminar will incur a $ fee.

5 The No Show policy for CIC Institutes also pertains to the Graduate Seminars.(CE Provider #0014) Certified Insurance Counselor2 018CE CreditsPersonal LinesApproved for 20 hours P/CCommercial CasualtyApproved for 20 hours P/CCommercial PropertyApproved for 20 hours P/CCommercial MultilinesApproved for 20 hours P/CLife & HealthApproved for 18 hours L/H, 2 hours LTC Agency ManagementApproved for 16 hours Any Line, 4 hours EthicsGraduate SeminarApproved for 12 hours P/C, 4 hours Ethics Institute/Date/Location Attendee NameNickname Designations System ID# (Found on your Insurance License)

6 National Producer # Agency/Company Street Address Box City/State/Zip Phone # Cell # Send confirmation/receipt to my e-mail address: In addition, e-mail confirmation/receipt to: ( credit card holder, accounting dept., agency owner)Registration Fees $430 CIC Institute - No CE $450 CIC Institute - With CE (Non-Michigan residents pay for CE to The Society of CIC at class)* $430 CIC Graduate Seminar (CE Included)*NOTE: Non-Michigan residents pay MAIA for the class ($430), but the extrafee for CE is paid to The Society of CIC during class due to price variations.

7 Three Payment Options1. Register online at 2. Pay by check to MAIA 3. Charge it and mail to the address, below. Total Charge $ VISA MC AMEX Discover Name on Card Card Number Expiration Date Please NoteIn accordance with Title III of the Americans with Disabilities Act, we invite all registrants to advise us of any disability and any requests for accommodation to that disability. Please submit your request as far in advance as possible for the program you wish to attend. If you have any questions, call (517) mail this form with your check to: MAIA 1141 Centennial Way Lansing, MI 48917 (800) 589-5065 or (517) 323-9473or email to National Alliance for Insurance Education & Research is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors.

8 State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN, 37219-2417. Website: Advanced Curriculum Rating = 20 CPE Credits. For more information regarding administrative policies such as complaint and refund, please contact our offices at (800) Documents\Education\CIC\ 2018 CIC\ (8/29/17)Registration FormOr register online at (Badge Name)(Must be registrants email)