Page 8 - Convergence of Professional Services 2020 - London, January 29-30, 2018
P. 8
DELEGATE COST: $ 600 per person
The registration fee includes all summit plenary programs on Tuesday, on January 30, 2018, including
conference breaks, conference materials, luncheon, and the one-to-one consultant session.
REGISTRATION: ( PLEASE TYPE OR PRINT )
To register, fill out and submit the registration form below in capital letters. Payment processing for your
delegate fee can be handled by credit card processing or bank wire transfer as outlined below.
Hotel options are separate fees and should be reserved directly with your preferred facility (see
Accommodation options details on next page). Please read our terms and conditions on page 7.
NAME TITLE and EMAIL
Registrant One : □ Registration □ Monday Dining Group
□ Registration □ Monday Dining Group
Registrant Two : □ Registration □ Monday Dining Group
$ 175 per person (additional)
Registrant Three :
Network Affiliation :
Optional Monday Dining :
Mobile / Cell Phone :
Primary E-mail :
REGISTRATION PAYMENT ( PLEASE CHOOSE ONE ONLY )
BANK TRANSFER DETAILS CREDIT CARD PROCESSING
Card Type : VISA MASTERCARD AMERICAN EXPRESS DISCOVER
Bank : Account Name : AILFN, Inc.
BBVACompass Full Name on Card:
6732082172
Account Number : 113010547 ____________________________________________
Routing Number : 062001186
CPASUS44 Card Number : ______________________________
ABA Number :
Swift Code :
IBAN : Not used by US banks Expiration Date : CVV : Postal Code:
______________ ____________
(REQUIRED)
____________
AMOUNT TO TRANSFER: in $ USD ________ TOTAL AMOUNT AUTHORIZED: in $ USD __________________
Please email this registration to contact@AILFN.com. Confirmation email will be sent to each registrant.
The registration fee includes all summit plenary programs on Tuesday, on January 30, 2018, including
conference breaks, conference materials, luncheon, and the one-to-one consultant session.
REGISTRATION: ( PLEASE TYPE OR PRINT )
To register, fill out and submit the registration form below in capital letters. Payment processing for your
delegate fee can be handled by credit card processing or bank wire transfer as outlined below.
Hotel options are separate fees and should be reserved directly with your preferred facility (see
Accommodation options details on next page). Please read our terms and conditions on page 7.
NAME TITLE and EMAIL
Registrant One : □ Registration □ Monday Dining Group
□ Registration □ Monday Dining Group
Registrant Two : □ Registration □ Monday Dining Group
$ 175 per person (additional)
Registrant Three :
Network Affiliation :
Optional Monday Dining :
Mobile / Cell Phone :
Primary E-mail :
REGISTRATION PAYMENT ( PLEASE CHOOSE ONE ONLY )
BANK TRANSFER DETAILS CREDIT CARD PROCESSING
Card Type : VISA MASTERCARD AMERICAN EXPRESS DISCOVER
Bank : Account Name : AILFN, Inc.
BBVACompass Full Name on Card:
6732082172
Account Number : 113010547 ____________________________________________
Routing Number : 062001186
CPASUS44 Card Number : ______________________________
ABA Number :
Swift Code :
IBAN : Not used by US banks Expiration Date : CVV : Postal Code:
______________ ____________
(REQUIRED)
____________
AMOUNT TO TRANSFER: in $ USD ________ TOTAL AMOUNT AUTHORIZED: in $ USD __________________
Please email this registration to contact@AILFN.com. Confirmation email will be sent to each registrant.
