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CBJ Workforce Leaders Awards
Wednesday, September 23, 2020
11:15 am - 1:15 pm

Virtual Individual Registration Rate: $20


ATTENDING VIRTUALLY REGISTRATION
* denotes required fields.

*Name

*Home Address

*City, State Zip

*Phone Number

*Email

*Company

Credit Card Payment
 Check this box if you would like to pay by Credit Card (Visa, MasterCard, Discover or American Express) and we will call you for that information within 24 business hours of submitting this form.
 
 
Invoice Company
Complete the following Company Billing Information for invoice processing (we do not bill individuals).
 

Company Name

Attention (person or department responsible for payment)

Company Billing Address

City State ZIP

Phone Number

 By checking this box, I have signed the agreement as the event participant and have received confirmation that my company will pay for me to attend and all fees should be invoiced to the company information that I have provided.