Individual Registration

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• CMS members: Please be sure you are logged in (top menu, right) for your membership discount to be applied.

Please complete the information below to register for the 2024 Southern Chapter Conference.

Prefix *

First Name *

Last Name *

Full Name for Badge (NO titles, please) *

Institution / Company / Organization (list only ONE) *

Mailing Address 1 *

Mailing Address 2

Mailing Address 3

City *

State *

Zip

Country *

Phone *

Email *

Friday Lunch Option - $10.51

Payment Information

Coupon

Amount

Discount Amount

Net Due

Payment Method

Paypal or Credit Card

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

Captcha*