WEM Registration Form

Full Name *

First Name Last Name

Law Firm *

What firm are you with?

Number of Years in Practice *

How long have you been practicing?

Email *

example@example.com

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

How many years have you attended WEM? *

0 1 2 3 4 5 6 7 8

Do you hold any leadership positions or state licenses? *

Please note what titles or licenses you hold. If you are a Third Party Neutral, please write "N/A" in the field.

My Products *

Lawyer Attendee

$ 750.00 # of Participants

Vendor Attendee Three (3) attendees are included with a WEM vendor ticket. Each additional attendee will be $1,500.

$ 6,500.00 # of Participants

Vendor Additional Attendee

$ 1,500.00 # of Participants

Paralegal Attendee

$ 450.00 # of Participants

Third Party Neutrals

Free

Total

$ 0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please list the name of those who will be attending with your practice. *

Specifically, for vendors who are registering and receive three (3) tickets. If this is not relevant to you, please write "N/A" in the field.

Based on the number of attendees you're bringing, please select the women's t-shirt sizes of each person.

S

M

L

XL

Attendee #1

Attendee #2

Attendee #3

Attendee #4 (If Applicable)

Attendee #5 (If Applicable)

Attendee #6 (If Applicable)

Based on the number of attendees you're bringing, please select the women's shoe sizes of each person.

5

6

7

8

9

10

11

Attendee #1

Attendee #2

Attendee #3

Attendee #4 (If Applicable)

Attendee #5 (If Applicable)

Attendee #6 (If Applicable)

Would you like to join the WEM listserv? *

Yes No I'm already on it

If "yes" to the above question, please provide two (2) member names for recommendation.

Conference Online Registration