SEHIA Registration for 5+ Attendees

Attendee 1*

First NameLast Name

Attendee 1 Cell Phone (needed for SEHIA app before and after conference)*

Please enter a valid phone number.

Attendee 1 Email*

example@example.com

Attendee 1 Charge

Attendee 1 Total Charge

Attendee 2

First NameLast Name

Attendee 2 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 2 Email

example@example.com

Attendee 2 Charge

Attendee 2 Total Charge

Attendee 3

First NameLast Name

Attendee 3 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 3 Email

example@example.com

Attendee 3 Charge

Attendee 3 Total Charge

Attendee 4

First NameLast Name

Attendee 4 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 4 Email

example@example.com

Attendee 4 Charge

Attendee 4 Total Charge

Attendee 5

First NameLast Name

Attendee 5 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 5 Email

example@example.com

Attendee 5 Charge

Attendee 5 Total Charge

Attendee 6

First NameLast Name

Attendee 6 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 6 Email

example@example.com

Attendee 6 Charge

Attendee 6 Total Charge

Attendee 7

First NameLast Name

Attendee 7 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 7 Email

example@example.com

Attendee 7 Charge

Attendee 7 Total Charge

Attendee 8

First NameLast Name

Attendee 8 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 8 Email

example@example.com

Attendee 8 Charge

Attendee 8 Total Charge

Attendee 9

First NameLast Name

Attendee 9 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 9 Email

example@example.com

Attendee 9 Charge

Attendee 9 Total Charge

Attendee 10

First NameLast Name

Attendee 10 Cell Phone (needed for SEHIA app before and after conference)

Please enter a valid phone number.

Attendee 10 Email

example@example.com

Attendee 10 Charge

Attendee 10 Total Charge

Agency Name*

Agency Phone Number*

Please enter a valid phone number.

Agency Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name

First NameLast Name

Name of Agency Person Responsible to Pay Registration Fee*

First NameLast Name

Email of Person Responsible to Pay Registration Fee*

example@example.com

Phone Number of Person Responsible to Pay Registration Fee*

Please enter a valid phone number.

Name of Person filling out Registration Form

First NameLast Name

Email of Person filling out Registration Form

example@example.com

CREDIT CARD CONFERENCE REGISTRATION

EARLYBIRD Conference Registration and SEHIA Membership for 5 Attendees Product Image

EARLYBIRD Conference Registration and SEHIA Membership for 5 AttendeesEarlyBird Conference Registration. Pay by credit card, PayPal, or check. All checks must be received by 8/31/2022 to get the discount. Annual SEHIA Membership is included in the fee.

$1,900.00

EARLYBIRD Conference Registration and SEHIA Membership for 6 Attendees Product Image

EARLYBIRD Conference Registration and SEHIA Membership for 6 AttendeesEarlyBird Conference Registration. Pay by credit card, PayPal, or check. All checks must be received by 8/31/2022 to get the discount. Annual SEHIA Membership is included in the fee for each person.

$2,280.00

EARLYBIRD Conference Registration and SEHIA Membership for 7 Attendees Product Image

EARLYBIRD Conference Registration and SEHIA Membership for 7 AttendeesEarlyBird Conference Registration. Pay by credit card, PayPal, or check. All checks must be received by 8/31/2022 to get the discount. Annual SEHIA Membership is included in the fee for each person.

$2,660.00

EARLYBIRD Conference Registration and SEHIA Membership for 8 Attendees Product Image

EARLYBIRD Conference Registration and SEHIA Membership for 8 AttendeesEarlyBird Conference Registration. Pay by credit card, PayPal, or check. All checks must be received by 8/31/2022 to get the discount. Annual SEHIA Membership is included in the fee for each person.

$3,040.00

EARLYBIRD Conference Registration and SEHIA Membership for 9 Attendees Product Image

EARLYBIRD Conference Registration and SEHIA Membership for 9 AttendeesEarlyBird Conference Registration. Pay by credit card, PayPal, or check. All checks must be received by 8/31/2022 to get the discount. Annual SEHIA Membership is included in the fee for each person.

$3,420.00

EARLYBIRD Conference Registration and SEHIA Membership for 10 Attendees Product Image

EARLYBIRD Conference Registration and SEHIA Membership for 10 AttendeesEarlyBird Conference Registration. Pay by credit card, PayPal, or check. All checks must be received by 8/31/2022 to get the discount. Annual SEHIA Membership is included in the fee for each person.

$3,800.00

Total

$0.00

PAYMENT OPTIONS*

PayPal or Debit / Credit CardCheck

CHECK OPTION:

If "Check" option is chosen, checks must be received before AUGUST 31, 2023.

Please PRINT this form using the button below and send, along with a check made out to "Southeastern Homicide Investigators Association: and mail to:

Send checks to:

SEHIA

ATTN: Jennifer Spears

PO Box 102

Sorrento, FL 32776

PAY BY CHECK CONFERENCE REGISTRATION*

EarlyBird Conference Registration for 5 Attendees - $1,900.00EarlyBird Conference Registration for 6 Attendees - $2,280.00EarlyBird Conference Registration for 7 Attendees - $2,660.00EarlyBird Conference Registration for 8 Attendees - $3,040.00EarlyBird Conference Registration for 9 Attendees - $3,420.00EarlyBird Conference Registration for 10 Attendees - $3,800.00

Total Invoice

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

EARLY BIRD REGISTRATION SEHIA ATTENDEE REGISTRATION for 5 - 10 ATTENDEES