2023 Benefit Seminars

1

Member's Name* This field is required.Please be sure to enter the member's name and not the spouse or dependent's name.

First Name

Last Name

2

MOE ID Number* This field is required.Your MOE ID number can be found on your Medical ID Card or Vendor ID Card.

3

Member's Contact Number* This field is required.

Please enter a valid phone number.

4

Member's Email Address* This field is required.

example@example.com

5

Please select the date/district of the Benefit Seminar you will be attending* This field is required.At each event, doors open at 8:15 a.m. and the presentation starts promptly at 9 a.m.

Saturday, December 2, 2023 - District 5 Union Hall (Utica, IL)

Saturday, December 9, 2023 - District 7 (Merrillville, IN)

Saturday, December 16, 2023 - District 1 (Countryside, IL)

6

Please let us know who will be attending this event.* This field is required.

Member Only

Member plus Spouse

7

Do you need a Spanish translator?* This field is required.Districts 1 & 7 may have a Spanish translator available, depending on demand.

YESNO