*1.Registration Information(Required.)

Name *

Company *

Address *

Address 2

City/Town *

State/Province *

AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming

ZIP/Postal Code *

Email Address *

Phone Number *

*2.Job Title(Required.)

3.Additional Registrations

1- Name

Title

Email

2- Name

Title

Email

3- Name

Title

Email

*4.Stifel Representative(Required.)

*5.ICBA Member?(Required.)

Yes

No

*6.Would you like CPE credit, if you meet time and participation requirements?(Required.)

Yes

No

7.Costs/Person:

Members: $595
Nonmembers: $695
Additional Registrations - Same Bank: $445/$545 (discounted prices)

An invoice will be sent shortly after registration.
Please make checks out to: Stifel

Please mail checks to:
Stifel
Attn. Colleen Ryan / Balance Sheet Academy
100 Motor Parkway 2nd Floor
Hauppauge, NY 11788

*8.Hotel Information:
The Peabody Memphis

149 Union Ave
Memphis, TN 38103
(901) 529-4000

For the event hotel group rate, click here(Required.)

I have booked my room

I will not need a hotel reservation

9.Any dietary restrictions