Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 3633 PARTICIPANT INFORMATION First Name: Last Name: Badge Name: Title: Organization: Shipping Address (P.O. Box not accepted): City: State: Zip/ Postal Code: Country: Telephone: Email: Register online at ilpa.org or submit completed forms to: Email: education@ilpa.org Fax: 416-941-9307 Mail: 55 York Street, Suite 1200,Toronto ON M5J 1R7 Canada By submitting this form the participant listed has read and agrees to the following terms and conditions. COURSE FEE: The fee entitles the registered delegate to attend all training sessions, and all meals and breaks. The fee also includes instructional materials. PAYMENT: Payment in full must be received priortothedateof theevent.Paymentscanbe made by AMEX, Visa, MasterCard, company check, or by wire transfer. If registering thirty (30) days or less prior to the event, delegates MUST pay by credit card upon registration. Bookings are confirmed on receipt of full payment of the program fee. Places are allocated in order of receipt of payment. CANCELLATION POLICY: Any cancellation received more than 30 days prior to the course will be subject to a charge of 50% of the program fee. All cancellations must be made in writing (by letter, fax or email - proof of receipt will be required). We regret that no refunds will be made for cancellations made within 30 days of a course. SUBSTITUTION POLICY: Substitutions within organizations are permitted, without penalty, at any time prior to the program’s commence- ment.No external substitutions may be made andundernocircumstancesmayregistrations be shared. Change of delegate request must be made in writing to nhizaka-vilardo @ilpa.org. POSTPONEMENT: A minimum class size per course is required. In the unlikely event that ILPA postpones an event, delegate payments already received will be credited to a future ILPA Institute event, on a date convenient to the attendee. FACULTY: Please be aware that all faculty were confirmed at the time of the published course, however, circumstances beyond the control of the organizers may necessitate substitutions, alterations or cancellations of the faculty.The ILPA reserves the right to alter or modify the faculty and/or course outline topics if necessary. PHOTOANDVIDEO RIGHTS:TheILPAreserves the right to use photos and/or videos taken during seminar activities for promotional or educational purposes. COURSE PREPARATION: By registering for this course you are agreeing to complete all pre-work required and come prepared to actively participate. DIVERSITY: The ILPA reserves the right to limit the number of participants from one organization to ensure a diverse learning environment. REGISTRATION FORM TERMS AND CONDITIONS Education (Degrees received): CFA Member ID # (If applicable): Member of the ILPA? Yes No ILPA is a registered sponsor on the National Registry of CPE Sponsors; do you require a NASBA Certificate of Completion? Yes No What type of organization are you from? PRIVATE PENSION ENDOWMENT FAMILY OFFICE FOUNDATION INSURANCE COMPANY INVESTMENT COMPANY PUBLIC PENSION SOVEREIGN WEALTH FUND OTHER (Please specify): Year started in private equity: Year started managing and monitoring a private equity portfolio: Please list any dietary restrictions: