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
http://www.starvedrocklodge.com/

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? *
Required
Will you be staying overnight in the hotel? *
I understand that I will have to pay $200 by September 1, 2017 *
Required
Payment
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:
ICIMA

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
Your answer
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms