2019 CWCEC Attendee Registration Form
2019 Colorado Workers' Compensation Educational Conference
March 25-27, 2019
www.wceduconference.com

The Colorado Workers' Compensation Educational Conference represents an opportunity for all stakeholders and industry professionals who participate in the Colorado workers' compensation system the opportunity to discuss the most critical issues facing Colorado's workers' compensation system and receive updates on current rules, procedures, policies and forms.

Attendee Registration = $375
Spouse/Companion Registration = $100
Exhibitor Attendee = $250

Please complete this form for each attendee or companion.

Type of Registration
Register
Attendee Registration - $375
Spouse/Companion Registration - $100
Exhibitor Attendee - $250
Attendee Information
Attendee First Name *
As it should appear on your name badge.
Your answer
Attendee Last Name *
As it should appear on your name badge.
Your answer
Title/Position *
Your answer
Company Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Zip *
Your answer
Phone *
Your answer
Email *
Your answer
Spouse/Companion Information
Spouse/Companion First Name
As it should appear on their name badge.
Your answer
Spouse/Companion Last Name
As it should appear on their name badge.
Your answer
Contact Information
Contact Information
Payment Online
DO NOT CLOSE THIS PAGE UNTIL THIS FORM HAS BEEN SUBMITTED.

Copy and paste the following address into a separate tab to pay online via credit card.

https://storesawca.com/t/2019-colorado-wcec

Enter your Order Confirmation Number in the field below.

Payment by Check
DO NOT CLOSE THIS PAGE UNTIL THIS FORM HAS BEEN SUBMITTED.

Please enter "check" into the Payment Order Confirmation Number field below.

Please make checks payable to SAWCA and mail to: SAWCA, PO Box 910373, Lexington, KY 40591

Payment Order Confirmation Number *
Your answer
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