F031AC62CC

Registration ID: F031AC62CC

Payment Details

Payment Method	The safer, easier way to pay. You do NOT have to have a PayPal account - simply pay with a credit card.
Registration Status	Incomplete
Subtotal	$1,050.00
Total	$1,050.00
Balance Due	$1,050.00 Pay Now

Registration Details

2015 CSIA Annual Conference	DPPA Event Center 2105 Decatur Street Denver CO 80211
October 20, 2015 - October 21, 2015
8:00 am - 5:00 pm	Qty
CSIA Members	5 x $110.00
Non-Members	4 x $125.00

Primary Registrant

CSIA Member Registration

Please fill in the information below for the person registering, and any additional attendees, if applicable. Note: if you are the person registering AND you are attending, make sure you list yourself as an Attendee.

First Name

Joel

Last Name

Cummings

Organization

Colorado Division of Workers' Compensation

Title / Position

Coverage Enforcement Unit Supervisor

Address

633 17th Street

City

Denver

State

CO - Colorado

Zip

80202

joel.cummings@state.co.us

Phone

3033188620

Full or Partial Attendance

Full Conference

Attendee 1: CSIA Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Jennifer

Last Name

Sells

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

Attendee 2: CSIA Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Kelli

Last Name

Elderedge

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

Attendee 3: CSIA Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Cindy

Last Name

Derzay

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

Attendee 4: CSIA Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Nikki

Last Name

Gwin

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

Attendee 5: CSIA Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Joel

Last Name

Cummings

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

Attendee 1: Non-Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Mike

Last Name

Hernandez

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

Attendee 2: Non-Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Susan

Last Name

Stenman

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

Attendee 3: Non-Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Margaret

Last Name

Clark

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

Attendee 4: Non-Members - 2015 CSIA Annual Conference

Conference Attendee

First Name

Troy

Last Name

Dumas

Organization

Colorado Division of Workers' Compensation

Meal Preference

Non-Vegetarian

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F031AC62CC

2015 CSIA Annual Conference

CSIA Member Registration

Conference Attendee

Conference Attendee

Conference Attendee

Conference Attendee

Conference Attendee

Conference Attendee

Conference Attendee

Conference Attendee

Conference Attendee

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