You are registering for:
FIRMA National Risk Management Training Conference
Las Vegas, NV
April 28 - May 2, 2013
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.
REGISTRATION DETAILS
* denotes required fields
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
Which Events Will You Attend? (please check boxes)
 Conference - $1695.00 ($1495.00 FIRMA members)
 Pre-Conference Workshop  - $300.00 ($225.00 members)
Which Seminar:
 In-Conference Seminar: Fiduciary Governance  - $225.00 ($150.00 members)
Conference Materials: Event and speaker materials/outlines will be posted to the FIRMA website in advance of the conference.
Mr./Ms. Full Name: *
Name for Badge: *
Title: *
Bank/Organization: *
Address: *
City: * State: * Zip: *
Phone: *
Fax:
Email Address: *
How Did You Hear About This Conference?: Other:
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Please Tell Us About Your Responsibilities: Other:
Please Tell Us About Your Job Function: Other:
Payment Type: Visa/MC/Amex/Discover     Please Invoice