2010 Washington Roundtable

This is the registration form for the 2010 Washington Roundtable. If you choose to make a payment online, you may do so through our secure Google Checkout option. However, you may also choose to pay by mailing a check to ICWP, 51 Monroe St., Suite PE-08, Rockville, MD 20850.



Last Name *
First Name *
Title
Agency
Address *
City *
State *
Zip Code * xxxxx
Email Address *
Phone *
Are you an ICWP member? *
Are you a WSWC member? *
Will you attend the full conference or just Thursday? *
Your name as it appears on credit card
What date will you check into your hotel?
Please tell us what date you plan to check out of your hotel.