Registration for the Blue Grass IMA
NOTE: IF YOU SELECT PAYPAL AS A PAYMENT TYPE, YOU MUST SELECT THE PAYPAL SIMPLE STOREFRONT OPTION AFTER COMPLETING THIS FORM. THANK YOU.
Month of meeting
First Name
Your answer
Last Name
Your answer
IMA member number
Your answer
Company Name
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Title
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Email address
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Meal choice
Want CPE?
Required
Payment Method?
Any additional Comments?
Your answer
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