Event Registration

Info Meeting/Open Enrollment Health Ins. Plans 2013 (am)

When:

11/19/2012
9:00 am

Where:

Kingston Holiday Inn
503 Washington Avenue
Kingston, NY 12401 [directions]

Cost:

Members: No Charge
Non-Members: No Charge
per person

Enter the attendees for this event. You can register up 10 attendees for each event.

Fields marked with an * are required.

1. * 2.
3. 4.
5. 6.
7. 8.
9. 10.

Company information:

Note: If your company is a member of the Ulster County Regional Chamber of Commerce:

Use the drop down box shown below to find your company so that the Company Information form can be pre-populated And so that you will receive any membership discount.



If you selected a company name by mistake, click here to clear the information

Company: * Note: Do not enter in your information to the left if you are a chamber member.

Instead select your company name from the drop down list above to pre-fill in this form.
Address: *
City: *
State: *
Zip: *
Phone: *
Email: *


Click the Continue button below to view the total for this event (and any others you have registered for) and payment options.