Application for the Post of Mentor for Appointed Actuary

1. Name of Applicant:
2. Contact details:
a. Address for Communication:
b. Mobile Number:
c. E-Mail id:
3. Citizenship:
4. Age & Date of Birth:
5. Professional Qualifications:
a. Specialization [Life / General / Health]
6. Details of previous experience as Mentor / Appointed Actuary in India or elsewhere:
7. Current assignments:
8. Achievements and special positions held presently or previously:
9. Work experience:
a. Total experience in Industry [in yrs]:
i. In Life Insurance:
ii. In General Insurance:
b. Post-qualification experience[in yrs]:
i. In Life Insurance:
ii. In General Insurance:
10. Details and validity of Certificate of Practice (CoP):
11. Expected remuneration: