registration iconREGISTRATION


YOU ARE REGISTERING FOR:


Meeting Title :
Company Name :
PIASC Account # :
Full Name :  
Email Address :  
Address :  
City :  
State :  *  
Zip Code : *    
Phone Number :  
* Numbers only, no dashes
Please check off which times you would like to attend the workshop:
(please choose one time per day)

Part A - Tuesday, January 24th *
8:00 am—12:00 pm
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1:00 pm—4:00 pm
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Part B - Wednesday, January 25th *
8:00 am—12:00 pm
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1:00 pm—4:00 pm
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* These fields are required.
Cancellation Policy: PIASC must receive cancellations 48 hours prior to the meeting to receive a full refund.


Questions?

contact: Emily Holguin

email: emily@piasc.org

phone: 323.728.9500, Ext. 262


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