Registration Form

Credit Union

Internal Auditors' Association

^{_______________}Helping Credit Unions Succeed^{_______________}

CONFERENCE REGISTRATION FORM

ATTENDEE INFORMATION (Please enter all information requested below)
Last Name		First Name					Middle Initial
Title						Name for Badge
CreditUnion/Company						E-mail Address
Street Address						City
State/Province			Zip/Postal Code
Phone Number
Fax Number				CUIAA ACUIA CUCP Member Non-Member
Conference Functions (Please state the events you plan to attend and submit one form for each attendee)
Check here if you may require special assistance. Explain in box provided.
Attending Sunday Welcome Reception? Yes No
Vegetarian Lunch Needed? Yes No
REGISTRATION FEES
			One Low Price		Amount Due
CUIAA, ACUIA & CUCP Members			$525		$
Non-Member CUIAA, ACUIA & CUCP			$625		$
(Includes one year membership in CUIAA)
Wednesday Only Sessions - Includes Lunch			$100		$
*All funds are to be paid in US Dollars *					$
BASED ON THE SCHEDULE, PLEASE INDICATE WHICH SESSIONS YOU PLAN ON ATTENDING. YOU ARE NOT LOCKED INTO THIS SELECTION, BUT IT WILL HELP THE CONFERENCE COMMITTEE WORK WITH THE HOTEL IN PLANNING THE NECESSARY SEATING ARRANGEMENTS.
		FRAUD/SECURITY			AUDIT/COMPLIANCE		SUPERVISORY COMMITTEE
Day 1 - Monday, August 17		B1			C1		D1
Day 2 - Tuesday, august 18
		B2			C2		C2

WAYS TO REGISTER AND PAYMENT INFORMATION
*Payment must accompany registration*
Credit Card. Payments are made through Paypal on the "Registration Confirmation Page" following the selection of the "Submit" button below. For multiple registrations, create and submit for each attendee - pressing the browser "Back" button until all are submitted. Then pay for all registrations after the last one is submitted - just be sure to select number of attendees for which you are paying in the "Quantity" section.
Check	Payable (US$) to CUIAA and Send to: Natalie Stout, Risk Management/ Internal Audit, California Coast CU, 9201 Spectrum Center Blvd, San Diego, CA 92123 Attention: CUIAA Conference
Cancellations: There are no cancellation penalties associated with this year's conference.
QUESTIONS: Web site www.cuiaa.org E-mail Andy Kecskes, akecs@cox.net or phone: 619-980-9831