H.I.T. CONFERENCE REGISTRATION
First Name:
*
Last Name:
*
Title/Rank:
Agency:
*
Phone Number:
*
Email:
*
Work Address:
*
TCOLE PID #:
*
City/State/Zip Code:
*
County:
*
Association Status
*
Please Select
Regular Member
Lifetime Member
Board Member
Payment Method
*
Personal Check
Agency Check
Cash at door
Purchase Order
PayPal
Association Status
*
Life Member
Regular Member
Board Member
Vendor
Purchase Order Number:
My Conference Registration
*
prev
next
( X )
Conference Registration - Lifetime Member
$
200.00
Quantity
1
2
3
4
5
6
7
8
9
10
Conference Registration - Non-Lifetime Member
$
300.00
Quantity
1
2
3
4
5
6
7
8
9
10
Pay Later
Cash at door
Check by mail
Purchase Order
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
Should be Empty: