Illinois AAHAM Spring Conference
April 5, 2018

Registrant 1
Name*
Title
E-mail*
Are you a member of AAHAM?*
If yes, please provide membership #
First Time at an AAHAM meeting?*
Certification:

Registrant 2
Name (Second Registrant)
Title (Second Registrant)
E-mail (Second Registrant)
Are you a member of AAHAM? (Second Registrant)
If yes, please provide membership # (Second Registrant)
First Time at an AAHAM meeting?(Second Registrant)
Certification: (Second Registrant)

Organization:
Address*
Phone*
-
Fax
-

Illinois AAHAM Spring Conference:
Registration:
Holiday Inn & Suites Bloomington Airport
Room Cost: $109.00 + tax
Group Code: AHG for IL AAHAM

Registration Deadline is March 28, 2017. Please send your payment by March 30, 2017.
Cancellation policy is 72 hours from date of event to receive credit for future event.

Payment information will be on the following page after the form is submitted.
Verification: