Attendees

Attendees

Wednesday, May 7, 2025 | Osage Casino Hotel - Tulsa
First Name*
Last Name*
Contact Information
Street Address*
City*
State*
Zip Code*
Email*

Confirmation EmailPlease confirm your email address. This will be how event information is communicated.
Phone Number*
Please enter a valid phone number.
CEU & License Information
Attendees desiring CEU’s must complete this registration form (including their LICENSE NUMBER), sign in for each qualifying presentation, complete the accompanying speaker evaluation, and return their paperwork to CMSA of Eastern Oklahoma.
Which option best describes you?*

I do NOT plan to claim education credits for attending this event.I plan to claim one type of education credit for attending this event.I plan to claim education credits under multiple licenses for attending this event.
License Type
License Number
License #2 Type
License #2 Number
Billing Information

Early Bird Rate is good through March 14. After March 14, standard rates apply!
Which option best describes you?*

I am attending as a non-member of CMSA ($150)I am attending as a member of CMSA ($120)I am attending as the guest of a booth sponsorI am attending as the guest of a corporate sponsorI am attending just for the luncheon ($50)
The cost for non-members to attend is $150. How would you like to pay?

Credit cardCheck
CMSA Member Number
The cost for CMSA members to attend is $120. How would you like to pay?

Credit cardCheck
Booth Company
Sponsor Company
The cost for just attending the luncheon is $50. How would you like to pay?

Credit cardCheck
Where should we send your receipt? (if different than the email address listed above)
example@example.com
Event Details
Dietary Restrictions

Gluten-freeDairy-freeVegetarianVeganOther
Do you plan to attend the cocktail hour on Tuesday, May 6?*

Yes, count me in!Unfortunately, I'm going to miss out.I am unsure at this time.
Tuesday RSVP
Total Due:
Should be Empty:

Attendees

Contact Information

CEU & License Information

Billing Information

Event Details