The Robert Zicklin Center for Corporate Integrity Presents:
The 10th Annual Audit Conference
December 3, 2015
Credit Card Payment Form
Please complete this form and send to Matthew.LePere@baruch.cuny.edu
Registration Fees:
$435 Single Registration
$3,000 for an eight person table (contact 646-312-3231 for more information)
$195 Academic and non-profit registration fee
Card Type*________________ Expiration Date______________Amount____________
Card Number_____________________________________________________________
Authorized Signature______________________________________________________
Contact Phone Number_____________________________________________________
Company________________________________________________________________
Print Name(s) of Registrant(s)_______________________________________________
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* We do not accept Discover
Please contact Matthew LePere at Matthew.LePere@baruch.cuny.edu or 646-312-3231
with any questions or information requests.
Special financial arrangements can be made for those who demonstrate financial hardship. Please contact
the Center for Corporate Integrity for information on guidelines and procedures. Determination of financial
hardship is made on a case-by-case basis. All requests are confidential.
Requests for refunds must be received in writing by November 18, 2015, and will be subject to a $100
cancellation fee. No refunds will be granted after November 18, 2015. For information regarding refunds,
complaint and/or program cancellation policies, contact Matthew LePere.