Annual Meeting - Legislative Dinner Registration Form

Annual Meeting

Wednesday - Thursday, January 15-16, 2025

Hawley Troxell, Base Camp Axe and Ping Pong

Boise, Idaho

Registration Form

Company Name / System*

Email*

example@example.com

Phone Number*

Area CodePhone Number

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Number of items our company will be contributing for the Silent Auction Wednesday Evening.

Registrant(s) Info

	First Name	Last Name	Title	Badge Name	Email	Phone #	Address	Guest Name
Registrant 01
Registrant 02
Registrant 03
Registrant 04
Registrant 05
Registrant 06
Registrant 07
Registrant 08
Registrant 09
Registrant 10
Registrant 11
Registrant 12
Registrant 13
Registrant 14
Registrant 15

Registration Options*

Event Attendee(s)$500.00

Reception, Wednesday Dinner, Games, Silent Auction, Thursday Breakfast, Speakers & Panels, Business Meeting, Raffle, Legislative Reception, Legislator Dinner

Quantity

Total $0.00

Credit Card

Please complete and submit the full information requested, of attendees as soon as possible.

Payment and Registration form will be sent directly to ICBA!

ICBA: PO Box 2634, Boise, Idaho 83701