ON-LINE REGISTRATION FORM

First Name:
Last Name:
Title:
Organization:
No. of Years in HR
Address:
City:	State: Zip:
Phone:
Fax:
Email:

Payment Information:
hr connection® member? YES NO
hr connection® members only: Yes,I will be attending the reception following the main program No, I will not be attending the reception following the main program
hr connection® Member Fee: $149.00 Non-Member Fee: $249.00
Team Discounts 10% discount available for teams of three or more from the same company. You must register at the same time and provide a single payment to take advantage of the discount. To take advantage of the Team Discount, call Karen Marrone at (612) 925-8347 to register.