IAPMO 90th Annual Education and Business Conference
REGISTRATION FORM

CONFERENCE REGISTRATION FEES
 Received by
8/23/2019
Received after
8/23/2019
ASSE/IAPMO Joint

Registration - Member *$575.00$645.00$800.00

Registration - Non-Member$670.00$750.00$945.00

Companion Member$465.00$515.00$630.00

Companion Non-Member$465.00$515.00$680.00

Day Pass - Member
(includes all that day’s education sessions and evening events)
$150.00$150.00-

Day Pass - Non-Member
(includes all that day’s education sessions and evening events)
$175.00$175.00-

Association Technical Meeting Convention
For those wishing to vote at this session only, you can do so at no cost, but registration is required by May 27, 2019 per IAPMO Bylaws Section 8.2A. After this date, those wishing to vote at the Association Technical Meeting Convention must register for the Conference at the noted registration fee.
$0.00$0.00-

Certification Exams
0.2 CEUs per session | Tuesday, Sept 24, 2019
* You won't be charged the fee at this time
$150.00$150.00-

Individual members paying for their own conference fees who are members on or before March 28, 2019 are eligible to vote as individuals.
* eMembers do not receive the discounted rate.

CONFERENCE REGISTRATION
Please select your registration choice:




Register My Companion Only
(requires current registration)


Fee: $670.00

To receive your membership discount, please enter your member number in the box below.
IAPMO Member No.    To pull up your current information, enter your member number and click the Search button.
First Name
Last Name
Badge Name - the name you would like printed on your badge
(if different from your full name)
Title  
Representing - your company name
Address  
City  
State  
Zip Code  
Cell Phone  
Telephone  
E-mail  
 
Is this your first IAPMO Conference?
I was referred by:
 
Companion Information  
First Name  
Last Name  
IAPMO Member No.  
Badge Name - the name you would like printed on your companion's badge (if different from their full name)
Companion E-mail  
 
Emergency Contact Name  
Emergency Contact No.  
 
Sign me up for the Roscoe King Memorial Golf Tournament:


DINNER CONFIRMATION
(Included with paid registration)
In order to better serve you, we request that you indicate which of the following events you plan to attend.
 


Special dietary needs


T-SHIRT SIZE
(Included with paid registration)
Registrant's T-Shirt size
 

Companion's T-Shirt size


MEMBERSHIP CLASSIFICATION



If you are a jurisdictional member, are you the designated voting member for the governmental jurisdiction you listed above?

(If you are the voting member of your organization please provide supporting document along with your conference registration.)

 

 

Start Over