Spring 2017 ICHRMA Conference

25th Annual Human Resources ConferenceRegistration Form

Date: Friday, May 4, 2018

Time: 8:00 am - 4:30 pm

Location: Lake Charles Civic Center

900 Lakeshore Dr.

Lake Charles, LA 70601

Registration

ICHRMA/SHRM Member Early Bird Registration $85.00

# of Registrants

ICHRMA/SHRM Member Registration (after April 15th)$95.00

# of Registrants

Non-Member Early Bird Registraton$110.00

# of Registrants

Non-Member Registration (after April 15th)$120.00

Total $0.00

Total Number of Registrants*

Company*

Title

BILLING ADDRESS Information

First Name*

Last Name*

Address

City

State

Zip

E-Mail Address*

Phone Number*

Registrant #1 Name*

Registrant #2 Name

Registrant #3 Name

By clicking "Proceed to Checkout" below, your registration form will be electronically submitted and you will be directed to submit payment via PayPal which has a credit card option. However, if you choose to pay with a check, then simply exit after you get the PayPal screen and mail check to address below.

Please continue by selecting your Payment Method below and clicking "Proceed to Checkout".

Payment Method*

PayPalMail Check: ICHRMA PO BOX 431, Lake Charles, LA 70602