HTCIA - Minnesota Chapter Conference Registration

Spring Conference Registration Form

Payment is preferred through via paypal by credit card but we will also accept checks. If you need an invoice, please email the chapter treasurer.

This form is for people registering to attend the conference. Presenters and vendors should use their respective registration pages.

*Note that refunds cannot be granted within 7 days of the conference date.

First Name:	A value is required.
Last Name:	A value is required.
E-Mail Address:	A value is required.Invalid format.
Title:
Agency:	A value is required.
Address Line 1:	A value is required.
Address Line 2:
City:	A value is required.
State:	A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
Zip Code:	A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
Phone:	A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
Membership Status:
Request WiFi Access?
Membership Number:	A value is required.