EM Essentials/EnrollMatch

Workshop
Registration Form
Chicago IL, November 12-14, 2014* 8:30 a.m. 5:00 p.m. daily
*(EnrollMatch Essentials is Day 1, November 12 only)
Location: 55 East Jackson Boulevard, 10
th
Floor Conference Room (Suite 1030)
Complete your registration today to ensure you have a seat!
Please register online at http://www.enrollmatch.com/upcoming-events.php or mail the registration form Attn: Kim
Tonelli, Norton|Norris, Inc., 55 E. Jackson Blvd., Suite 950, Chicago, IL 60604, Fax to 312-262-7450, or scan and email to
kim@nortonnorris.com. You are also welcome to call Kim at 312-262-7405 to register by phone.
PLEASE TYPE OR PRINT
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Phone Click here to enter text. Fax Click here to enter text.
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ADDITIONAL REGISTRANTS
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Nov 12 EnrollMatch Essentials Workshop Payment: $199 per person (includes 1-day workshop and all materials)
Nov. 12-14 EnrollMatch Workshop Payment: $795 per person (includes 3-day workshop and all materials)
Check or money order payable to Norton|Norris, Inc. enclosed.
Please invoice me. Attn: Click here to enter text.
Credit card payment to be submitted by telephone

Thank you for your registration. Limited space is available on a first registered, first served basis. Payment must be received in full before the date of
the workshop. No refunds for cancellations with less than a 24 hour notice. A 50% fee will apply to cancellations received less than 7 days prior to
workshop.