INTERNATIONAL CREDIT EXECUTIVES GROUP OF WI
 Wisconsin Credit Association
ICE Group Online Registration
DATE: Wednesday January 25, 2012
2012--YEAR OF THE ECONOMIC DRAGON Led by CHRIS KUEHL
MEETING LOCATION: Hilton Garden Inn Park Place
Milwaukee WI

Please fill out this form to register for the upcoming ICE Group Meeting. If you require a copy, print the form before clicking the SUBMIT button. Please be sure to complete this registration form completely before clicking SUBMIT. If you do not receive a meeting confirmation, please contact the Association no later than one week before the meeting to confirm receipt of your online registration.

Meeting Fees & Registration Details
$50 Per Person all representatives from ICE Member Company
$95 Per Person all others

Fees include full-day meeting, refreshments and lunch. Sorry, no credit or refund for no shows or cancellations within seven (7) days prior to the meeting. Substitutions are permitted with prior notice to WCA. Please contact Dianna at the Association, 262.827.2880 X225 with any questions. Thank You!

Is your company an ICE member:
(ICE Group Member fee is $50 per person)
(Full Day fee is $95 per person)

* Required Fields
* Company:
* Street Address:
* City:
* State:
* Zip Code:
* Telephone Number: ( )
* Fax Number: ( )
* E-Mail Address:

Include designations with your name (CCP, CPC, CICP, CICE, other) Attendee Name:
Attendee Name:
Attendee Name:
Attendee Name:

Method of Payment
Invoice My Company (BCMA/WCA & ICE Members Only. All others are asked to prepay)
Check Enclosed (or in the mail)
Credit Card
Please note that this is not a secure site. You may submit your credit card information via this form, however WCA assumes no liabiity. You may also call the WCA office at 262.827.2880 to provide your confidential credit card information or fill out this form, print it, and fax to 262.827.2899.

Type of card:
Name on card:
Billing Address:
City State & Zip:
Card Number:
Expiration Date:

Comments / Special Information / Open Discussion Questions: