Form

H.I.T. CONFERENCE REGISTRATION
First name:*
Last name:*
Title/Rank:
Agency:*
Contact telephone number:
Email
Address:*
TCLEOSE PID #:*
City/State/Zip code:*
County:*
Association Status*
Payment Method*
Purchase Order Number:
Important information, the registration fee for Non-Life members is $200.00, with late registration after March 31,2012 being $225.00. If you are a Life Member, your registration fee is $150.00.
Should be Empty:

H.I.T. CONFERENCE REGISTRATION