Institute of Actuaries of India

302, Indian Globe Chambers, 142, Fort Street, Off D N Road, Fort, Mumbai 400 001 Tel: 022 67843333 Fax: 022 67843330

APPLICATION FORM FOR NOVEMBER 2011 EXAMINATION

[Last date of Receipt of Application: 3rd September, 2011]
Membership No:

Paste one stamp size photograph and attach one more and write your name on the back side of photograph

Surname First Name Middle Name Short Name Father's Name Date of Birth (DD/MM/YYYY) Whether students / associates membership has been renewed for the year 2011-12? If Yes, give Receipt number and date, if Not, please renew your membership first and then apply for examination. Receipt No./Date Amount DD No./ Date

Examination Centre [Please tick the centre where you wish to appear]
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Mumbai Kolkata Delhi Hyderabad Kanpur Chennai Bhopal Bangalore Lucknow Cuttack Coimbatore Chandigarh Pune Thiruvanthapuram Jaipur Ahmedabad

Subject for which you wish to enroll (Please ensure subject code & subject name is written correctly)
Subject Code Subject Name
Study Material Purchase Receipt No Exam Fees (Rs.)

13. 14. 15. 16.

TOTAL Note:

{Change of Centre will not be considered after 15th September, 2011}

Students enrolling for the examinations should ensure to have purchased the Study Material for the subject/s appearing; otherwise they will not be allowed to appear in the examination. Please enclose the copy of receipt of Study Material purchased. Please also ensure you have latest study material upgrades.

Examination fees remittance particulars (Please refer Notes 1 & 2) (Payment by DD/Pay order (PO) will only be accepted) Amount Demand Draft No. Name of the Bank Dated Enclosure Details of Communication only for the purpose of Examination (in Capital Letters & fill all the section) Name & Complete Postal Address

E- Mail Tel No (O) Tel No (R) P I N Code : Mobile No.

Date:

/ 2011

Place:

SIGNATURE

Please Note: Incomplete application form will not be accepted & will be returned back. Only one form will be accepted from one candidate. Consolidated DD/PO will not be accepted. Demand Draft should not be stapled but attached with U pin.

NOTES 1. Examination Fees: Subject CT Series Subjects CA1 ST Series Subjects SA Series Subjects 2. Rates applicable to students of India and SAARC Countries INR Rs. 1,200 per subject INR Rs. 4,000 INR Rs. 2,500 per subject INR Rs. 2,600 per subject Rates applicable to students appearing from other than SAARC countries US Dollars $ 80 per subject /INR 4000 per subject US Dollars $ 225 /INR 11250 US Dollars $ 120 per subject /INR 6000 per subject US Dollars $ 120 per subject /INR 6000 per subject

Mode of Payment:(a) Applicants from India and SAARC countries should make payment by Demand Draft/PO in Indian Rupees (INR) while applicants from other than SAARC countries should make payment by US Dollars or in Indian Rupees (b) DD/PO should be drawn in favour of Institute of Actuaries of India payable at Mumbai. (c) Cash and Cheques will not be accepted. Students are requested to send the DD/PO for Examination fees, Study material fees & Subscription fees separately. Consolidated DD/PO will not be accepted. (d) Please write at the back of DD/PO Your Name, Contact no, Examination Fee for November 2011 Exam & Subject Code.- (e) Please check if DD/PO has been duly signed by bank authorities & it is of requisite amount. (f) DD/PO sent directly through bank or otherwise without duly filled examination form will not be accepted. Membership subscription: Student Members, who have paid the subscription for the Year 2011-2012(i.e. April 2011 March 2012) will only be permitted to appear for the Examination. Hence, this should be remitted (if not already paid) with penalty of 25% of subscription along with the Application Form for Examination. Current Subscription rates: Resident in India Rs. 500/Rs. 1000/Resident outside India (US Dollars) $ 70 $ 100

3.

Student Associate

Kindly contact subscription dept. to Ms Vijaya at 67843302 or actsoc@actuariesindia.org for further details. 4. POINTS TO NOTE: a. b. c. d. Application should be in the prescribed Form only. Last date for receipt of the Examination Form by the Institute of Actuaries of India is 3rd September, 2011. Last date for receipt of Examination Form along with late fees of 25% is 10th September, 2011. 50% of exam fees will be refunded, if application, for withdrawal is received before 15th September, 2011 along with original exam receipt. Please send your request to Sandeep at Exam dept. at sandeep@actuariesindia.org e. The request for change of examination centre/subjects will be entertained up to 15th September, 2011. Please send your request to Sandeep at Exam dept. at sandeep@actuariesindia.org f. Examination Admission card giving Candidate Roll Number & address of Venue of the Examination will be sent by 4th week of October 2011. g. If, for any reason, the examination Admission card is not received in time, the original examination fee payment receipt issued should be produced along with Identity Proof at the Examination Centre where the Supervisor will inform the Roll Number and permit to appear for Examination/s. h. You may contact the Institute for any information you require on course material, syllabus and examination. i. Candidate can appear only from one centre. Ticking on more than one centre will be considered invalid. j. A candidate who have not passed or do not have credit in CT9 subject will have to pass the same before appearing in CA, ST & SA level subject. k. Only one form will be accepted from one candidate. Candidate submitting more than one form will be treated as invalid. l. Exam forms received after last date will be returned back.

P.S.: In case you do not receive the hall ticket by 28th October 2011, or any query relating to examination, please contact Sandeep Mahajan or Ulhas Pokharkar at IAI office by E-mail at: sandeep@actuariesindia.org or ulhas@actuariesindia.org or by Telephone at 022 6784 3333 Extn. 304/315

Institute has issued Photo Identity Card in the month of March to all students including Associate Members. This is compulsory Identification for attendance during the examinations start from November 2011 Examination Diet. Please Carry the same during the Examination. If you have not received Kindly contact Ms. Nilima at studymaterial@actuariesindia.org.

Timetable November 2011 Examination

Date & Day 08/11/2011 Tuesday 09/11/2011 Wednesday 11/11/2011 Friday 14/11/2011 Monday 15/11/2011 Tuesday 16/11/2011 Wednesday FORENOON Subject CA1 Actuarial Risk Management (Paper I) CT6 Statistical Methods CT4 Models CT2 Finance and Financial Reporting CT7 Business Economics From To AFTERNOON Subject From To

9.45* 13.00 Hrs. CT3 Probability & Mathematical Statistics 10.00 13.00 Hrs. CA1 Actuarial Risk Management (Paper II) 10.00 13.00 Hrs. ST7 General Insurance : Reserving & Capital Modelling ** 10.00 13.00 Hrs. ST2 Life Insurance

15.00 - 18.00 Hrs. 14.45* - 18.00 Hrs. 14.45* - 18.00 Hrs. 14.45* - 18.00 Hrs. 14.45* - 18.00 Hrs. 15.00 - 18.00 Hrs.

10.00 13.00 Hrs. ST4 Pensions &Other Employee Benefits 9.45* 13.00 Hrs. CT1 Financial Mathematics SA1 Health and Care Insurance 9.45* 13.00 Hrs. SA2 Life Insurance 9.45* 13.00 Hrs. SA3 General Insurance SA4 Pensions & Other Employee Benefits 9.45* 13.00 Hrs. 9.45* 13.00 Hrs. SA5 Finance 9.45* 13.00 Hrs. SA6 Investment 10.00 - 11.00 Hrs. CT9 Business Awareness Module 10.00 13.00 Hrs. ST1 Health and Care Insurance 17/11/2011 CT5 General Insurance, Life and Health Contingencies Thursday 10.00 13.00 Hrs. ST5 Finance and Investment A 18/11/2011 CT8 Financial Economics Friday 9.45* 13.00 Hrs. ST8 General Insurance : Pricing ** 21/11/2011 ST6 Finance and Investment B Monday

14.45* - 18.00 Hrs. 14.45* - 18.00 Hrs. 14.45* - 18.00 Hrs.

AM: 9.00 9.30 *9.45 10.00 10.00 13.00 Note Room Preparation Students enter room Reading time Exam Duration

PM: 14.00 14.30 *14.45 15.00 15.00 18.00 Room Preparation Students enter room Reading time Exam Duration

1) * Includes 15 mins. for reading of question paper. Thereafter, candidates will have three hours for writing the

answers. 2) CT9 BAM Exam can only be taken by those who have already attended two days CT9 course & have got FA/FB grade in the examination conducted at the end of two day course.