2013 Reg II

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MOUNTAI NS OF OPPORTUNI TY in 2013

Asheville, NC

Crowne Plaza Hot el & Resort

March 21 24, 2013

Name: ______________________________________________ Designations: _______________________________

Nam e for Badge: ___________________________ _________ Local Associat ion : ___________________________ __

M ai l ing Add ress: ______________ _____________________ __________________ __________________ __________

E-M ai l Add ress: ____________ ________________________ __________________ _______ _____________________

Employer: ______________________________________________________________________________________

Hom e Phone #________________ W ork #___________________ Cel l #___________________ Prefer red #_______

Check all that A pply:

__Alt ernat e __DA E __Founders Cir cl e __ Nat io nal Of f icer / Past Of f ice r

__CIIP/ CPIW / CPIM __De legat e __Gu est __Ot her__________ ______ _

__CW C Con t est an t __Exh ib it o r __Loca l Presiden t __Counci l Di rect o r / Past CD

__Fir st Tim er __M em ber @ Lar ge

Designation s received in the p ast 12 m ont hs: CIIP/ CPIW/ CPIM , DAE, othe r: _____________ _____________________ _

Event # Cost Tota l Du e

Registration in cludes a ll m eet in gs, m eals, & CE $ 2 1 5

Late Registrat ion Postmarked Af te r 02 /25 / 13 $ 2 3 5

Daily Registrat ion includes M eals$ 1 0 la t e f e e a ft e r 2 / 2 5 / 1 3

Thursday or Fr iday on ly $ 1 0 0 p e r d a y

Satur day Only $ 1 5 0

Addit iona l M ea ls:

Frid ay Lunch $4 0

Fr iday W elcom e Par ty $5 0

Saturday Bi ltm ore Estate Tour , D inner & Transpor t at ion $ 1 2 5

Thursday M arch 21st CE

PIAM Com m ercial Auto - 7 Hr. CE Al l Region I I Stat es Included

Profe ssion al Eth ics: A Personal Choice -3 Hr . CE Included

Cybe r Liabil i ty 3 Hr. CE All Region II Stat es Included

Strat egic Plannin g (CLP) (Discount ed Stu den t Guide) $2 5

Social Net w orkin g CE Pending Included

M aking Change Wo rk for You (D iscounted Stud ent Guide ) $1 0

Fundr aising Tables $25

Special Dietary Requirements: ______________________________________________________________________

Auxi l iary Aids/ Services Requ ired: ____________________ _______________ _____________________ __________

REGISTRATION DEADLINE: Februa ry 25, 2013 . NO REFUND S AFTER M ARCH 8, 201 3

$25 cance l la t ion fee for request rece ived betw een Feb 25 , 2013 and M arch 8 , 2013Full refun ds for requ est prior to Feb 25, 2013

M ake checks payable to: 2013 Region I I Conferen ce Fund , c/ o Brenda W ebster 118 Country Place Rd, W i lmington NC 2840

HOTEL INFORM ATION: The ho tel has b locked room s for u s unt i l February 20 , 2013 . Room rates are $96.00 King/ Double

$106 King Executive one & Two Bedro om Vi l las $145 & $165 respectively. Al l rates per night p lus appl icable tax. For

Reservat ions use our custom l ink h t tps :/ / r esw eb.passkey.com / go/A IW2013MAR or Cont act Crow n Plaza at

888.233.9527 Group ID AIW. Af ter Feb 20, 2013 or for t he Vi l las you m ust cal l 800.733.3211 for reservat ions.

CONFERENCE CHAIRSTracy Cot to n 828.713.8614 tco t tonw [email protected] or Bi l lie Sleet 828.243.500 1 bas leet@bel lsouth.net

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Asheville, NC

Crowne Plaza Hot el & Resort

March 21 24, 2013

W e d n e sd a y , M a r ch 2 0 , 2 0 1 3Conf erence Setu p - Al l Conf erence Com m itt ee Chairs 1:00 pm - unt i l

Thursday , M arch 21 , 201 3

Registrat ion - Class Att end ees 8:00 am - 9:00 am

PIAM - Com m ercia l Auto - 7 Hr . CE - Al l Region I I Sta te s 9 :00 am - 5 :00 pm

Professional Eth ics: A Persona l Choice - 3 Hr. CE 9:00 am - 12:00 pm

IAIP Leadership Tra in ing - (Open to anyone w ho isseeking an IAIP Lead ership position) 9:00 am - 11:00 am

Cyber Liabil ity - 2 Hr. CE - All Region I I Stat es 10:00 am - 12:00 noo n

Lunch - Class Att ende es - Hospi tal i ty Sui te Noo n - 1:15 pm

Strat egic Planning (CLP) (Course from new Lead ership 1:00 pm - 5:00 pm

Designat ion Program - Course 1 o f M odule 1 )

Registrat ion and Creden tials Open 2:00 pm - 6:00 pm

Socia l Net w ork ing - 3 Hr . CE (appl ied for ) 2 :00 pm - 5 :00 pm

M aking Change W ork for You ( IAIP Class) 2 :00 pm - 4 :00 pm

Nom inat ing Com mi t tee 2:00 pm - 5:00 pm

Dinner on Your Own - Shut t les to Down to w n 6:00 pm

Host Hospi ta li ty Sui te Open 6:00 pm - 9:00 pm

Fr iday , M arch 22 , 20 13Cont inent al Breakfast 7:00 am - 8:30 am

Exhib i tor Set-U p 7 :00 am - 9 :00 am

CW C Brief ing 8:00 am - 8:45 am

Delegates Br ief ing 8:45 am - 9:30 am

Registrat ion and Creden tials Open 8:00 am - 3:00 pm

Exhib i ts / Fundra isers Open 9 :00 am - 12 :00 noon

Com mit t ee M eet ings (15 m inute intervals) 9:00 am - 10:00 am

Youn g Professionals M eetin g 9:45 am - 10:15 am

First Tim ers 10:30 am - 11:15 am

Luncheo n - CPIW / CPIM 12:00 noo n - 1:30 pm

Exhib i ts Open 1 :30 pm - 3 :00 pm

General Session 3:00 pm - 5:15 pm

Exhib i ts Open 5 :30 pm - 9 :00 pm

W elcom e Recept ion/ Dinner w i th Exhib itors 6 :00 pm - 9 :00 pm

Hospi ta l i ty Sui te Open 9:00 pm - 11:00 pm

Saturday , M arch 23 , 2013Cont inent al Breakfast 7:00 am - 8:00 am

Registrat ion and Creden tials Open 7:00 am - 8:15 am

General Session 8:15 am - 12:30 pm

Bil tm ore Excurs ion 1:00 pm - 9:00 pm

Hospi ta l i ty Sui te Open 9:30 pm - 11:00 pm

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in Asheville, NC

Cr owne Plaza Hot el & Resor t

Mar ch 21 24, 2013

CON VENTION VOLU NTEER

You can gain valuable netwo rk ing oppor tun i t ies and exper ience the w ork ings of th e convent ion t hrough you r

involvement at th e Region I I convent ion.

Not e Delegates CANNOT serve o n Tel lers, Creden tials or Tim ekeeper s Com m itt ees.

Co mmit te e Du t ie s

Registration Dist r ibut e at t endee packets and r ibbons. D ist r ibut e exhib i tor packets .

Tellers Count votes at each general session e i th er by paper bal lots or s tanding head coun tof de legates must be p resent at ALL business m eetin gs.

Credentials Register d elegates and al ter nates and m ake sure de legates and al ter nate s areseated in the appropr iate areas dur ing a l l m eet ings.

CW C Faci l i ta te the speak-of f and assist w i th t he prep m eet ing ons i te

Pages Del iver messages and assist as need ed w ith h ando ut s etc. befor e and dur ingbusiness m eetings.

Timekeepers M ust be present at ALL business meet ings, the Delegates Br ief ing, M eet t heCandidat es and CWC speak-off to t im e the speakers

M in u te s Ap p r o va l Assist Convent ion Secretary in rev iew and approval of convent ion m inutes

TransportationCoordinators

Assist w i th Travel excursion to Bi l tm ore Estate including distr ibut ion of t ickets,lunches and guardianship of gu ests.

Vo lu n te e r Sta te m e n t

As a registered At t endee, I w ant to h elp at the convent ion and I request assignment to t he fo l low ing com mi t tee(s) .

First choice __________ ________________ Second Choice ________________ _____________

Name _________________________________________

Em ai l ___________________ __________________ _ Phone ______ __________________ _

Associat ion ____________ _____________________ _______________ ____ Stat e __________ _____

Please return t his form w ith your registrat ion

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in Asheville, NC

Cr owne Plaza Hot el & Resort

March 21 24, 2013

__________________________________________________________________________

2013 CONTINUING EDUCATIONENROLLMENT FORM

Course Name: PIAM COMMERCIAL AUTO 7 Hrs. CE All Region II StatesCourse Number:Instructor: Sylvia Robinson, CIC, CPIW, DAE

Central Insurance School

Course Date/Time: Thursday, March 21, 2013 9:00 am 5:00 pmRegistration 8:00 am 9:00 amClass begins promptly at 9:00 am

Location: Crowne Plaza Hotel & ResortOne Resort DriveAsheville, NC 28806

COMPLETED REGISTRATION FORM for this session must be received with your conference registrationform no later than February 25, 2013.

Please print or type in black ink Use a separate form for each class participant.

Full Name: _________________________________________________ [ ]Mr. [ ]Ms. [ ]Mrs.Last Name First Name Middle Initial

Nickname for Badge: ___________________________ Designations Held: _______________

NPN# (required for CE credit): ________________________ Date of Birth: ________________

Agency/Company Name: ________________________________________________________

Mailing Address: _______________________________City: ___________State: ____Zip ____

Email Address: ___________________________Business Phone: __________________

If you have any questions, please contact: Roberta Clodfelter at 336-889-8282or Billie Sleet at 828-243-5001

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in Asheville, NC


Mar ch 21 24, 2013

__________________________________________________________________________


Course Name: PROFESSIONAL ETHICS: A PERSONAL CHOICE 3 Hr. CE WV, NCCourse Number: TBDInstructor: Rita Kidd, AAI, ARM, APA, CISR, CIC, CPIW

Course Date/Time: Thursday, March 21, 2013 9:00 am 12 Noon

Registration 8:00 am 9:00 amClass begins promptly at 9:00 am


COMPLETED REGISTRATION FORM for this session must be received with your conference registration nolater than February 25, 2013,


Full Name: _________________________________________________ [ ]Mr. [ ]Ms. [ ]Mrs.Last Name First Name Middle InitialNickname for Badge: ___________________________ Designations Held: _______________






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Mar ch 21 24, 2013__________________________________________________________________________


Course Name: CYBER LIABILITY 2 Hr. CE All Region II StatesCourse Number: TBDCourse De scription : Expo sure Environm en t, Risk Ana lysis Perspectives, an d Coverage s Ava ilable

Instructor: Kevin Pow ersAccoun t Execut ive Of ficerTravelers Bond & Finan cial Products - Private & No n-Profit

Course Date/Time: Thursday, March 21, 2013 10:00 am 12 NoonClass begins promptly at 10:00 am


COMPLETED REGISTRATION FORM for this session must be received with your conference registration nolater than February 25, 2013,









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Mar ch 21 24, 2013

__________________________________________________________________________


Course Name: Strategic Planning Course from Module 1 of New CLP DesignationCourse Description: IAIP Course Course from Module 1 of the New CLP Designation

CPIW/CPIM QualifierIf you and the people who work with you dont understand where the company is going,they may all develop their own priorities and actually prevent you from getting where youneed to be. Part of getting everyone on board is creating a strategic plan complete withthe organization.

Instructor: roz horton, CIC, CPIW, DAEIAIP International Vice President

Course Date/Time: Thursday, March 21, 2013 1:00 pm 5:00 pmClass begins promptly at 1:00 pm


COMPLETED REGISTRATION FORMAND COST OF Materials $25.00 for this session must be mailed withyour conference registration no later than February 25, 2013.









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March 21 24, 2013

__________________________________________________________________________


Course Name: SOCIAL NETWORKINGCourse Number: TBDInstructor: Kimberly Shattuck, CISR, CPIW, CPIA

Regional Sales ManagerAmTrust North AmericaAlpharetta, GA

Course Date/Time: Thursday, March 21, 2013 2:00 pm 5:00pmClass begins promptly at 2:00 pm


COMPLETED REGISTRATION FORM for this session must be received with your conference registrationform no later than February 25, 2013.









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Mar ch 21 24, 2013__________________________________________________________________________


Course Name: Making Change Work for You

Course Description: IAIP Course CPIW/CPIM QualifierMaking Change Work for You is a workshop designed to help you manage the changesin your life.

Instructor: Sharyn Clark, CPCU, CPIW, DAE

Course Date/Time: Thursday, March 21, 2013 2:00 pm 4:00 pmClass begins promptly at 2:00 pm


COMPLETED REGISTRATION FORMAND COST OF Materials $10.00 for this session must be mailed withyour conference registration no later than February 25, 2013.









2013 Reg II

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Transcript of 2013 Reg II