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Diversity Exam Reimbursement Program Application

The Society of Actuaries/Casualty Actuarial Society Diversity Exam Reimbursement Program is available to the following groups that are under-represented in the actuarial profession: African American, Hispanics, and Native North Americans. An applicant must be either a U.S. citizen or have a permanent resident visa. This reimbursement program is not designed for individuals employed full-time in an actuarial position.

Date of Exam:
Exam Passed 1(P) 2 (FM)
Minority Group:
Last Name:
First Name:
Middle Name:
Address:
City:
State/
Canadian Province:
Zip/Postal Code:
Country:
Phone:
E-mail:
Are you a Student or Career Changer? Student
Career Changer
If student, where do you attend school?
What is your major?
What is your highest level of education achievement?
If you have earned a college degree, please specify:
School(s):
Degree(s):
Major(s):
Are you employed?
If you are employed, what is the nature of your work?

Are you a U.S. Citizen? Yes
No
If no, what type of visa do you have?
If no, what is your place of birth?
Would you like to be put in contact with a member of the Committee on Actuarial Diversity? Yes
No

Optional Information


Gender:
Date of Birth:

Exam Reimbursement Agreement

Submitting this form for exam reimbursement, means you agree with the following:

  1. To the best of your knowledge, you have provided complete and truthful information.
  2. You have not been reimbursed for this exam from any other source.
  3. Please note that actuarial candidates are bound by the Code of Conduct for Candidates.

It's important that actuarial candidates understand and apply this code. In particular Rules 1 and 2 apply here.

They are:

RULE 1: An Actuarial Candidate shall act honestly, with integrity and competence, to uphold the reputation of the actuarial profession.

RULE 2: An Actuarial Candidate shall not engage in any professional conduct involving dishonesty, fraud, deceit, or misrepresentation or commit any act that reflects adversely on the actuarial profession.