Event Registration

Fax to: (608) 204-9818

Mail to: 2830 Agriculture Dr.
Madison, WI 53718

Full Name:

Title/Position:

Company/Affiliation:

Address:

City:		State:	Zip:
Phone:		Fax:	Email:

Registration	8:30-9:00
Morning Presentation	9:00-11:15	Workshop - Key Legal Developments: EEO-1 Reporting, Background Checks and Legal Issues for Wellness Programs
Lunch & Announcements	11:30-12:15
Keynote	12:15 - 1:15	Keynote - *Annual Legal Update*

Registration Fees

Morning Workshop Only	Lunch & Keynote Only	All Sessions
__ $30 GMA SHRM Member	__ $35 GMA SHRM Member	__ $55 GMA SHRM Member
__ $40 Non Member	__ $40 Non Member	__ $70 Non Member
__ $10 Students	__ $10 Students	__ $20 Students

Method of Payment - Pre-payment required for non GMA SHRM members.
Total to be charged: _________ Mastercard Visa Credit Card Number: Exp. Date:
Three digit verification number (on back of credit card):

Name as it appears on card:
Billing Address for Credit Card:

Please contact the GMA SHRM office if special assistance or meal requirements are needed.
No refund will be given for cancellations after noon on Friday, March 16, 2007.

GMASHRM Headquarters
2830 Agriculture Dr. :: Madison, WI 53718 :: Phone: (608) 204-9814 :: Fax: (608) 204-9818 :: Email: chapteradmin@gmashrm.org