2018 Southern Regional Conference
Secure Registration Form
Credit Card Required
* Most fields are required
Full name
*
First name
(as preferred for badge)
*
Title
*
Company/Organization
*
Address
(where credit card is authorized)
*
City
*
State
*
Zip
*
Phone
*
Fax
Email
*
Number of attendees
*
Workshop
Pre-conference workshop
Check here if you are attending the pre-conference workshop on lead hazard control and healthy housing technical issues including changes to the HUD Lead Hazard Control Guidelines, Lead Safe Housing Rule and new Lead in Dust Clearance Standards. (Add $45)
Registration Rates
For those registering after September 1, 2018:
For 1 person from an organization $275
For 2 or 3 persons from an organization $250 per person
For 4 or more persons from an organization $225 per person
Payment Amount
(to be charged)
*
Credit card number
*
Card Code (CCV) - Typically on back of card
*
Exp Month (Numeric)
example 01 = January
*
Exp Year (Numeric) example 2013
*
Name on card
*
REGISTRATION CANCELLATION POLICY: Cancellations must be in writing. Refunds will be given to all requests received up to 72 hours before the first day of the conference, less a $45.00 cancellation fee. No refunds will be given for “no shows”.
