Application Form :

Thank you for choosing to attend INSURANCE DISTRIBUTION CHANNELS CONVENTION. ACISP wants to make the process as easy as possible.
  You will need to complete a separate registration form for each individual attending.
  Denotes REQUIRED Fields.

 Title :
 Gender :





 Who will be responsible for Payment?
Information about academic and other qualifications:
Institution Other Qualifications Major Graduation
Review Requirements :
Module 1 Module 2 Module 3
Certificate
Diploma
Advanced Diploma
Associate

Special dietary requirements:

 
Participation Fees should be deposited to:
A/c Name – AFRICA COLLEGE OF INSURANCE AND SOCIAL PROTECTION LTD
A/c No: 0150481024400 at any CRDB branch.
  All cheques should be addressed to : Africa College of Insurance and Social Protection.
  Submit the original pay-in slip to ACISP Training Facility at Masaki-Oysterbay, 386 Toure Drive, No.99.