Charlotte Check IT Out

Charlotte Conference - February 26-27 2010 - $125.00

Please complete this form FOR EACH PERSON attending the Check-IT-Out Conference.
To Learn more about the conferenece, read Frequently Asked Questions
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First Name *

Last Name *

Mailing Address *

City *

State/Province *

Postal Code *

Email Address *

Current Job Title

Primary Phone *

Work Phone

How did you hear about Check-IT-Out?

If other please enter how you heard of us below.

Attending Pre-Conference Activities? ($25.00)

Taking the JAARS Center Tour

Need Airport Shuttle?
$$ to be collected at conference

On Center Housing

If yes, are you willing to share?

Room Sharing with...
If sharing, enter your the name of your roommate.

Friday Breakfast ($5.00)
Included free with Pre-Conference Tour

Arrival Date /Time
MM/DD/YY HH:MM AM/PM

Departure Date/Time
MM/DD/YY HH:MM AM/PM

Flight Information
Enter Airline, Flight Number, Departing and Arriving Cities

What attracts you to Check-IT-Out?

What do you hope to gain from the conference?

Special Needs
Enter any special needs (for example, dietary restrictions, or wheelchair access)

Code *
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