Register

2020 National Premium Tax Conference Registration Form

Virtual Event November 9-12, 2020

Fee: $100 per person

 

Registration closes October 25, 2020

Time left to register: 5 days, 17 hours, 17 minutes ago

PLEASE COMPLETE ALL FIELDS

Attendee Last Name: *
Attendee First Name: *
Business Email Address: *
Business Telephone: *
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Mobile Telephone: *
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Company Name: *
Company Address: *
Company NAIC Group: (Use 00000 if N/A) *
Company NAIC Group Code: (Use 00000 if N/A) *
Company Type: *
Premium Tax Experience *
May your Company Mailing Address be given to Credit Syndicators? *

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Pay by Check – Make Payable to:

    National Premium Tax Conference
    c/o Jan Gillerin
    90 Maynard Street
    Northborough, MA 01532