First Name:     MI:   Last Name:

E-mail:          

Title:               

Bank/Firm: 

Address:      

City:                State:

Zip Code:      

Telephone:   Fax:

Immediate Supervisor:      
(Name and title)

Telephone:  

In case of emergency, contact:

Telephone:  

Fee Schedule
$1,995 per registrant for NYBA members (Members of the Connecticut and Massachusetts Bankers Associations may register at the member rate)
$2,145 per registrant for non-members

$440 per registrant single room supplement

The fee covers the cost of double room, most meals, tuition and instructional materials.  A limited number of single rooms are available at an additional cost of $440 per registrant.  Single rooms must be paid in advance.

Payment Information
Mail check (payable to New York Bankers Association)
Please invoice me (for member banks/firms only)
Credit card - please call 212-297-1666 with number, or fax form to 212-297-1683 with credit card information
       (MC or Visa only accepted) - provide card type, number, exp date and 3-digit security code

Billing Address for Credit Card Payment

First Name:    Last Name:

Bank/Firm: 

Address:      PO Box allowed

City:             State: Zip Code:  

Country:   

Cancellation Policy
Registrations cancelled on or after May 16, 2008, are subject to a $300 charge.  Registrations cancelled prior to May 16 will be refunded in full.  Cancellations on or after May 23, 2008, are subject to a $600 charge.  There is no charge for substitutions.  Requests for refund must be made in writing to the NYBA office.

Applicant Background Information

For rooming, if applicable: 
Smoker  Non-smoker
Male       Female
Age   Roommate Preference (name):

Educational Background (check highest level attained)
High School
Some College
Associate Degree
Bachelor's Degree
Master's/MBA Degree 
Law Degree
Other Advanced Degree

Total Years Trust/Estate Experience
Less than 2 years
2-4 years
5-7 years
8-10 years
11-15 years
16-19 years
20 years and above

Approximately how much of your time do you spend in the following areas?
New Business     %
Administration  %
Investments      %
Tax                       %
Other                   %

Please print this page for your records before submitting.