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CMC-S Affiliate Leadership Conference

July 18 & 19, 2022

Rancho Bernardo Education Center
11111 Rancho Bernardo Rd.
San Diego, CA 92127

Instructions

If you are the person responsible for payment, your information will be collected at the end of the form.

Please enter the email and mailing address of each attendee. You will be able to add a different mailing address for the billing information.

There will be no refunds for cancellations after July 1. There is a $25 cancellation fee.

Please select from one of the options below. If you are registering more than one person, you can add additional registrations.

For groups attending virtually - Choose "I am registering myself" as the option and select the group virtual registration option. You will be able to add up to 10 names.

I am registering just myself.

I am registering someone else, a group, or myself as part of a group.

Event Registration

ok to print

CMC Member Type

Proof of Vaccination

Cancellation Fee

You are registering for the following event:
(Current:23) (Available:105)

In Person - $130

Individual Virtual - $70

Group Virtual - $70

Please select how many attendees you are registering:

Is the mailing address for each attendee the same?

Yes

Group Mailing Address

Group City

Group State

Group Zip

If you are attending as a member of a CMC-South Affiliate, please indicate which affiliate.

Subtotal:

Contact/Billing Information

As the primary contact, you will be able to make changes to the registrations including uploading a copy of the PO if you receive it after submitting this registration. An email with the link and login information will be sent to you along with a copy of the invoice and all of the registration information.

Each registered attendee will receive an email of their registration information.

*Required

*First Name

*Last Name

*Organization

*Mailing Address

*City

*State

*Country

*Zip Code

*Phone Number

*Email

Special Requirements
(ie: dietary, mobility, etc.)

Are you paying by purchase order?

Yes

PO Number

Please upload a copy of the purchase order.

If you do not have it now, you can upload it at a later date. Instructions will be emailed to you.

Do not upload anything other than purchase orders.

Payment Options

Summary

Discount Code:

Discount:

Total (USD):

Deposit:

Credit Card MasterCard

You will be prompted to enter card details after submitting this registration.

Check

We will email you an invoice with payment instructions.

Purchase Order

No refunds given after July 1. There is a $25 cancellation fee.

Questions?
If you have any questions, please contact James Short at [email protected].

Please wait while we process your registration.
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