Form Owner:
www.aimirs.org
Step 1 of 3: Submit
54th ABMTS Registration Form
'AIM - Assured, Inspired & Motivated'
Registrant Information
Last Name
*
First Name
*
Member
*
Yes
No
AIM Member Number
Address (Line 1)
*
Address (Line 2)
City
*
State
*
Select an option:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
*
Business Phone
Personal Phone
*
eMail
*
Chapter Affiliation
*
Known Allergies - This Box must be completed. NONE is acceptable. Please be specific.
*
Employment Info
Employment
*
IRS
Retired
Other
Grade
Registration Options
1st Timer?
*
Yes
No
NOTE: Each item below includes a processing fee to cover the cost of electronic payment.
NOTE: If doing a payment plan, choose None below and skip to Payment Plan Options.
Registration (Includes all standard tickets)
Member - GS-5 & below ($156 USD)
Member - GS-6/7Retired/Non-IRS ($260 USD)
Member - GS-08 & Above ($286 USD)
Non-Member ($312 USD)
Jr. Conference ($78 USD)
None (skipping to payment plan options)
NOTE: Subsequent payment plan payments require completion of Registrant Information section above.
Payment Plan Options (Covers registration only)
None
Pymt Plan (GS-5 & Below) 1 of 2 ($52 USD)
Pymt Plan (GS-5 & Below) 2 of 2 ($53 USD)
Pay Plan (GS-6/7/Non-IRS) 1 of 3 ($87 USD)
Pay Plan (GS-6/7/Non-IRS) 2 of 3 ($87 USD)
Pay Plan (GS-6/7/Non-IRS) 3 of 3 ($87 USD)
Payment Plan (GS-8 & Above) 1 of 3 ($92 USD)
Payment Plan (GS-8 & Above) 2 of 3 ($92 USD)
Payment Plan (GS-8 & Above) 3 of 3 ($92 USD)
Please enter Jr. Conference Registrant Name, Age & Conference Shirt Size below.
Conference T-Shirt (Included with your registration): Please select size
*
None
SML
MED
LRG
XL
XXL
3XL
4XL
Additional Tickets
None ($0 USD)
Opening Session ($42 USD)
Leadership Forum ($37 USD)
1-Workshop ($37 USD)
2-Workshops ($74 USD)
3-Workshops ($110 USD)
1-Social Mixer / Networking ($58 USD)
2-Social Mixer / Networking ($115 USD)
1-Hospitality Suit ($58 USD)
2-Hospitality Suite ($115 USD)
1-Gala ($63 USD)
2-Gala ($125 USD)
3-Gala ($188 USD)
Additional Comments
Payments will be processed through PayPal. Therefore, you will see an additional fee per registration item. If you do not have a PayPal account, you can still submit your payment by clicking "Pay with Debit or Credit Card" at the bottom of the Paypal.
*
indicates required fields