ICIMA 2017 Fall Conference Registration
Event Timing: October 5 & 6, 2017

Event Location: Starved Rock Lodge & Conference Center
Event Address: 2668 E. 875th Road. Oglesby, IL 61348

Contact us at 630-444-3080 or laskycharles@co.kane.il.us

Cost: $200 per attendee

Email address *
Name *
Your answer
Phone Number *
Your answer
County *
Your answer
What days will you attend? *
Will you be staying overnight in the hotel? *
I understand that I will have to pay $200 by September 1, 2017 *
Please complete this form and submit payment for $200 per attendee by September 1, 2017 to:

ICIMA c\o Kane County I.T. Department
Attn: Charles Lasky
719 S. Batavia Ave
Geneva, IL 60134

Paying by Check:
The check must be made out to:

Paying by Credit Card:
If you would like to pay by credit card, email laskycharles@co.kane.il.us and he will send you a PayPal request to pay which will allow you to pay by credit card or follow this link: https://paypal.me/ICIMA/200

Thank you for joining us for the 2017 Fall ICIMA Conference

Would you like a payment request sent to your email so you can pay by credit card without a PayPal account: *
Other comments or requests
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