Registration Demand

Prefix*
—Please choose an option—Mr.Mrs.Ms.Dr.

Address

Street *

Street 2

Zip Code *

Country *

Ext

Additional Information

Name to Appear on Certificate (full seminar registrants only)

Continuing Legal Education

Continuing Legal Education Credit for (States)

Bar Numbers

(Requests for CLE must be received at least 45 days before the seminar and may incur additional fees for application/attendance reporting.)

Payment

Payment Source *
—Please choose an option—Bill My EmployerPay by Credit Card

Purchase Order Number

Discount Code

Apply Discount

Credit Card Information

Name on Card

Card Number

Expiration Month

Expiration Year

Security Code

Select if same as Registration Address

Billing Address

Street

Street 2

City

State

Zip Code

Send Receipt/Confirmation to (separate by comma)

IAML's Taxpayer ID Number: 95-3548502