Registration Form

Payment must accompany your registration form, unless you will be wiring the funds. Admittance to the Workshops will not be allowed unless payment is received. No refunds will be given for cancellations received within 21 days of event ( * - Required Field).
Company & Contact Information
*Name:
*Company:
*Address:
*City:
*State
*Zip/Postal Code:
*Country:
*Telephone:
Fax:
*E-Mail Address:
Please contact me about my special needs with accommodations, meals or other needs.
   
  Register 21 days prior for discounted advance registration fee.
   
Event to Attend
 
Please note the North American Workshop and EuroForum are open to ICMA members only.

Early Discount Registration Deadlines (21 days prior to event)
– Register by: September 23 for the Chicago Workshop and October 7 for the Prague EuroForum.

NOTE: Registration for these events after these deadlines will increase by $25 (per event).

Check all that apply:

   
Payment Method
Credit Card
VISA
MasterCard
American Express
Discover
Credit Card #:

Exp. Date (e.g. 03/99):

Name on Card:
Wire Transfer information requested
 




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