3280 Progress Drive, Suite 700
Orlando, Florida 32826
407-882-0260 Fax: 407-882-0244
ceevents@ucf.edu
Kenneth G. Dixon School of Accounting 35th Annual Accounting
Conference
First Name:
_______________________________
Title:
_______________________________
City:
_______________________________
Daytime Phone Number:
_______________________________
Last Name:
_______________________________
Company:
_______________________________
State:
_______________________________
Evening Phone Number:
_______________________________
Date:
______________________________
Address:
______________________________
Zip Code:
______________________________
Email:
______________________________
Vegetarian Meal : Yes
No
Special Needs: ______________________________________________________________________________________
IMA Number (if applicable) :
o
Early Any 1 Day Conference Registration
(on or before April 8, 2016) US $295.00
o Early Any 2 Day Conference Registration
(on or before April 8, 2016) US $460.00
o
o
o
Early All 3 Day Conference Registration
(on or before April 8, 2016) US $590.00
o
Regular Any 1 Day Conference Registration
(after April 8,2016)
US $330.00
Regular Any 1 Day Conference Registration
(after April 8,2016)
US $515.00
Regular Any 1 Day Conference Registration
(after April 8,2016)
US $675.00
IMA Registration *Must provide IMA Number*
o IMA Early Any 1 Day Conference Registration
(on or before April 8, 2016)
o IMA Early Any 2 Day Conference Registration
(on or before April 8, 2016)
IMA Registration *Must provide IMA Number*
o IMA Regular Any 1 Day Conference Registration
(after April 8, 2016)
o IMA Regular Any 2 Day Conference Registration
(after April 8, 2016)
o
o
IMA Early All 3 Day Conference Registration
(on or before April 8, 2016)
IMA Regular All 3 Day Conference Registration
(after April 8, 2016)
Total: $____________________
PAYMENT INFORMATION:
Mail to: Division of Continuing Education 3280 Progress Drive, Suite 700 Orlando, FL 32826 or Fax to: 407-882-0244
☐ Payment enclosed. Make checks payable to University of Central Florida. Please make sure you have name and address on check.
☐ Purchase Order #
☐ Credit Card #
Expiration Date:
Circle: Visa / MasterCard / American Express / Discover
Name as it appears on card:
☐ Billing address same as above.
Or provide billing address here:
Signature
By registering for the UCF Accounting Conference you acknowledge that the conference organizers may share
your name and contact information with other conference attendees.