Fiduciary & Investment Risk Management Association FIRMA Conference Registration Form Member Non-Member Register & Join Conference & Workshop Conference Only Workshop Only Full Name: Name for Badge: Title: Email Address:    Full Name: Name for Badge: Title: Email Address:    Full Name: Name for Badge: Title: Email Address:    Bank/Organization: Address: City: State: Zip: Phone: Fax: Email Address: Visa MasterCard American Express Discover Card # Exp. Date Authorized Amount to Charge Please Invoice. I am part of a group registration Note: Registrations for group discounts must be submitted in a single registration for all individuals in the group for disounts to apply. Click Send Registration Form to send or Erase All to start over: By Mail Copy and mail this complete form to FIRMA, PO Box 48297, Athens, GA 30604 By Telephone Call us at (706)354.0083. Business hours: Monday-Friday, 8:00 to 5:00 EST. By E-Mail Our E-Mail address is thefirma@negia.net. By Fax Send this completed form to (706) 353.3994. Travel Call Action Travel at (800) 854.0601 ext. 3012 for travel arrangements.