Registration form only non-Government Pre-Registration Fee: $ 105. 00
Download 35.85 Kb.
|
- Navigate this page:
- Registrations Must Be Postmarked by October 1, 2017
- MAKE ALL CHECKS PAYABLE TO
- ATTENDEE INFORMATION Company and Title WILL NOT
- Pre-Registrants Names Title Email Address
- Jane Smith
- PAYMENT INFORMATION Date form completed by key contact: _______________________
- Onsite Registration Information
|
102nd Annual League Conference Atlantic City Convention Center November 14-16, 2017 NON-GOVERNMENT PRE-REGISTRATION FORM ONLY Non-Government Pre-Registration Fee: $105.00 No Refunds, Cancellations, Faxes or Emails Registrations Must Be Postmarked by October 1, 2017 222 West State Street, Trenton NJ 08608 
MAKE ALL CHECKS PAYABLE TO: NJLM, 222 West State Street, Trenton, NJ 08608 Non-Municipal Registration Form Only Key Contact Information Organization: _________________________________________________________ County: ______________________________ Key Contact First Name: ____________________ Last Name: ________________________ Title: _________________________________ (CONFIRMATIONS WILL ONLY BE SENT TO KEY CONTACT. IF YOU ARE ATTENDING THE CONFERENCE, PLEASE REGISTER BELOW) Address: ___________________________________________________ City: _______________________ State: ______ Zip Code: ____________ Telephone ( )______________ Fax ( )_______________ E-mail____________________________________________________
ATTENDEE INFORMATION Company and Title WILL NOT show on Non-Municipal Badge (Print or Type all required information below)
PAYMENT INFORMATION Date form completed by key contact: _______________________ All non-government registrants must submit a check with this registration form. All forms received without a check enclosed will be returned unprocessed. Number of Registrants _________ @ $105 each = Check Amount $______________ Check Number enclosed_____________ * PAPER Registrations must be postmarked by October 1, 2017 * WE DO NOT ACCEPT FAX OR EMAILED REGISTRATIONS – THEY WILL NOT BE ACKNOWLEDGED OR PROCESSED *NO REFUNDS OR CANCELLATIONS, You may transfer a badge to another *THE TRANSFERRED BADGE must be presented at the Pre-REGISTRATION counter “If an NJLM event is cancelled by NJLM, registration fees for that event will be refunded in full. Modification of events will not be cause for refunds.” NJLM USE (ONLY) Date recv’d _______ Chk recv’d______
FOR DATA ENTRY PERSONNEL USE (ONLY) Check, all that apply to confirm accuracy of this Order Registration Type: _____Non-Municipal Registering by: ____Check# _______ Amt $_________ Onsite Registration Information Onsite registration begins Tuesday, November 14, 2017 9:00 am Onsite Non-Government Fee $125.00 This form is not valid for onsite registration Directory: 2017conf Download 35.85 Kb. Share with your friends:
| ||||||||||||||||||||||||||||||||||||||||||||||||