| You are registering for:
FIRMA National Risk Management Training Conference
Fort Worth, TX
March 25 - 29, 2012
Please note: Early prices are shown on this form until the early registration deadline of February 15, 2012. After that date, regular prices will apply. Please see the conference brochure for details. |
Registration Instructions
Please fill out the form below. When you submit this form, you will be asked to confirm your registration information. After you have confirmed your registration details, if you have chosen to use a credit card, you will be redirected to our secure server to enter your credit card information.
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REGISTRATION DETAILS
* denotes required fields
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| Membership: | FIRMA Non-member
Discounts are available for groups of 5 and 10 attendees. For details, please contact Amy Caple at the FIRMA Office -- (678) 565-6211 or amy@thefirma.org |
| Are You a Regulator: | YES |
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Which Events Will You Attend? (please check boxes)
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| Conference Handouts:
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All Conference attendees will receive a CD that contains the conference materials, speaker outlines, and handouts.
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| Mr./Ms. Full Name: | * |
| Name for Badge: | * |
| Title: | * |
| Bank/Organization: | * |
| Address: | * |
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| City: | *
State: * Zip: * |
| Phone: | * |
| Fax: | |
| Email Address: | * |
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| How Did You Hear About This Conference?: | Other: |
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| What Is Your Organization's Profile?: | |
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| Please Tell Us About Your Responsibilities: | Other: |
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| Please Tell Us About Your Job Function: | Other: |
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| Payment Type: | Visa/MC/Amex/Discover Please Invoice |
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