Late Non-member Registration

Late Non-member Registration - $450

Focus Area: *

Please select your primary focus area.

Full Name: *

Email: *

School or Business Name: *

Phone: *

Billing Address

Address Line 1: *

Address Line 2:

City: *

State: *

Zip Code: *

Are you registering a guest in addition to yourself:

If yes, you will receive an invoice for $150 to cover the cost of Wednesday and Thursday evening meals, please provide the guest's name:

Would you like to participate in the Grand Lake Queen cruise? (Space is limited): *

Meals provided: for catering purposes, please verify your participation in which evening meals: *

If you have any special needs or accommodations, please note here::

How would you like to pay?: *

Online

Check ($25.00 fee for Returned Checks)

If you select online, you will be redirected to PayPal after submitting this form. If you select check or PO, you will be given the mailing/fax information to send your payment.

If you are paying by check, please list the check #:

If you are paying by PO, please list the PO #:

Customize Business & Industry Training Services (CBITS)

Late Non-member Registration - $450