Certificate in Employee Benefits Law Seminar Select Location/Date * Atlanta, Georgia April 21, 2025 Las Vegas, Nevada October 6, 2025 Registration Prefix* —Please choose an option—Mr.Mrs.Ms.Dr. First Name * Last Name * Professional Title * Employer * Email * Business Phone * Address Street * City * State * Zip Code * Country * Payment Payment Source * —Please choose an option—Bill My EmployerPay by Credit Card Please Note: Your credit card will not be charged now. We will call to confirm your registration and your card will be charged your card once confirmed. Credit Card Information Name on Card Card Number Expiration Month Expiration Year Security Code Purchase Order Number Discount Code Apply Discount Send Receipt/Confirmation to (separate by comma) IAML's Taxpayer ID Number: 95-3548502 Have a question? Call us Now (949) 760-1700