MAPCast Registration Form

IT Trends and Disrupters
Tuesday, October 31, 2017
02:00 PM ET / 01:00 PM CT / 12:00 PM MT / 11:00 AM PT [Prevailing Time]
Presenter: Roman Kepczyk, CPA.CITP, CGMA, PAFM, Director of Consulting, Xcentric
Cost: PAFM (Free), *PCPS and CPAFMA Members ($25.00), Non-Members ($40.00)
*PCPS promotion code required for member rate.

Registration Type:

PAFM

CPAFMA Member

PCPS Member

Non-Member

Name:

Firm/Company:

Address:

Country:

Phone:

Email:

Listing of Additional Participants: Full name and email is required for each

Full Name

Email

Total Cost:

Certificates of Attendance (CPEs) available at no additional cost.

Send me information about becoming a member of CPAFMA. If I join within 30 days of the MAPCast, I understand the fee difference will be credited to my membership dues.

Billing Information Same as above

Name:

Company:

Address:

Country:

Phone:

Payment Information

Promotional Code:

Valid promotional discounts will be calculated during processing.

Payment Method

Visa

Mastercard

American Express

Invoice Me

Card Number

Expiration Date

CVV2 Code:

(3 or 4 digit code on back of card)

Cardholder's Name