| First Name:
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| Last Name:
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| Job Title:
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| Company:
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| Address: |
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| City:
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State: |
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Zip: |
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| Phone: |
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| E-mail:
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| ISACA Member? |
Yes
No
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| Certifications? |
CISA
CISM Other:
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| Registration Fee: |
If
paying by check, mail
your completed registration form and check to: Central Indiana ISACA P.O. Box 441257 Indianapolis, IN 46244-1257
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| Chapter Recognition Credits:
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Chapter Recognition Credits may be redeemed for up to 75% of the Registration Fee.
What are Chapter Recognition Credits.
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| Attendee List: |
As a service to meeting attendees and speakers, and to
promote networking opportunities, the Chapter occasionally provides a
meeting attendee list containing contact information (e.g., name, company, address, phone number, e-mail, etc) to those
individuals attending a chapter-sponsored event.
Yes,
Please include me on the attendee list distributed to Meeting
Attendees
No,
I DO NOT want to be included on the attendee list |
| Cancellation: |
Substitutions may be made at any time
and registrations canceled up to 2 weeks before the event with no
charge. Those who do not cancel with 2 week notice and do not attend are
responsible for the full fee.
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IMPORTANT: Click the
"Proceed to Payment" link at the bottom of the next page if you
plan to pay by credit card, bank transfer, or paypal funds.
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