Please fill out your registration information as completely as possible. Fields marked with ** are REQUIRED and must be filled in! |
** Event |
Adjudication Certification Training
Wed, November 8, 2023, 8:30am - Thu, November 9, 2023, 12:00pm
Las Vegas, NV, NV
Tuition: $550.00 |
Registrant Info (the person filling out this form) |
** Registrant First Name |
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** Registrant Last Name |
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** Registrant Email |
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** Registrant Phone |
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Attendee Info (the person actually attending the event) |
Social Title (Dr/Mr/Ms/Etc) |
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** Attendee First Name |
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Attendee Middle Name |
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** Attendee Last Name |
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Attendee Name for Certificates and Nametags |
Enter the attendee name as it should appear on certificates, nametags, sign-in sheets, etc. (if different)
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** Tribe/Organization/Company |
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** Title |
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** Attendee Email |
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** Attendee Phone |
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Attendee Cel |
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Attendee FAX |
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** Attendee Street |
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Attendee Street 2 |
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** Attendee City |
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** Attendee State/Province |
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** Attendee Zip/Postal Code |
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** Attendee Country |
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Additional Info |
** Registrant Background |
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** Payment Method |
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** Billing Email |
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** Billing Name |
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** Billing Address - Street |
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Billing Address - Street 2 |
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** Billing Address - City |
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** Billing Address - State |
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** Billing Address - Zip |
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** Billing Address - Country |
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Other Information |
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How did you hear about the event |
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** Accept Registration Terms |
IMPORTANT - PLEASE READ!
You will be responsible for the registration fee if you cancel after seven days prior to the training event.
Check to AGREE. (See Terms and Policies) |
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