REGISTRATION

* Required Field

First Name*:
Last Name*:
Badge Name (Informal first name)*:
Firm or Business*:
Email*:
Admin Email:
Street Address*:
City*:
State:
Zip Code*:
Phone*:
CA Bar Number:
CA CPA Number:
By registering for the Symposium, I grant the program organizers permission to use my personal information for event management,
event payment and recognition as an event attendee. Yes     No
What is your service type?*:
If Other selected, please specify:
ADA Requests?*
Yes     No
If yes, please specify:
Dietary Food Restrictions?*:
Yes     No     Vegetarian
If yes, please specify:
Which Meals do you plan to attend?
Friday Breakfast*
Yes     No
Friday Luncheon*
Yes     No
Friday Welcome Reception*
Yes     No
Saturday Breakfast*
Yes     No
Will you be attending the Thursday Networking Dinner at the Westin from 6-9 pm? Cost is $90.*    Yes     No
If yes, please choose your entree:
Chicken     Salmon     Steak     Vegetarian
Would you like to join other attendees for a “no host” dinner at a local restaurant on Friday night?*    Yes     No
Are you a member of the California Receivers Forum?*
Yes     No
If yes, please indicate your chapter:
Bay Area     Central CA     LA/OC     Sacramento     San Diego

Seminar pricing includes:

Welcome Reception • Breakfast & Lunch Friday, Breakfast Saturday • All Refreshment Breaks
Educational Materials • MCLE & CPE Credit

Contact the CRF Administrator at CRFadmin@JBSMgmt.com for Loyola VII Sponsor & Exhibit information.

REGISTRATION FEES

Last Chance | February 15, 2017 – March 3, 2017 – $699

 

Speakers – Please contact the CRF Administrator at CRFAdmin@JBSMgmt.com for speaker registration rates and private registration link.

PAYMENT INFORMATION

Registration Fee:
$
Thursday Networking Dinner:
$
Amount Due:
$
I will be paying by:
Credit Card    Check
cclogos
Credit Card Number:
Expiration Date (MM/YY):
 last 2 digits of year only ex: 19 not 2019
Name on Card:
CVV Code:
Billing Zip Code:
Cancellation notification received prior to February 1, 2017 will be refunded less a $50 service charge. Transfers from one individual to another member of your organization are at no charge prior to February 1, 2017. Transfers February 2, 2017 – March 3, 2017 are charged a $50 service fee. No refunds for cancellations or no-shows after Februrary 2, 2017.
 
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