2018 BCI Summit Registration Page 2018 BCI Summit Registration Form Register for the 2018 BCI Summit! Delegate Registration InformationPlease complete a registration form for each delegate. The full session and speaker schedule will be posted prior to the event, and is subject to change.Delegate Name* First Last Title*Email* Work Phone*Cell Phone*We ask for your cell phone number in case we need to contact you for any reason while at the conference. Professional DesignationNoneCertified Business Associate (CBA)Certified Business Fellow (CBF)Certified Credit Executive (CCE)Master in Business (MBA)Certified Public Accountant (CPA)Attorney (Esq)Company InformationCompany Name*Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Financial Officer/Controller*Financial Officer/Controller Email* Is your company a member of BCI?*YesNoConference Registration Options:Conference Registration:*2 Day Delegate: $550Monday Delegate: $250Tuesday Delegate: $250You are a Winner!!!Payment & ApprovalTotal Payment Due: $0.00 How would you like to pay for your conference registration?* Invoice Me Credit Card - After completing this form you can pay via credit card using our online credit card payment process to insure a timely and secure payment. Please use the invoice code: BCISUMMIT - followed by your last name or names of registrants. if paying for multiple registrants in one transaction. BCI Terms and Conditions General: Payment for all sales of products, education and services are due within 30 days of invoice date, after which the invoice is considered delinquent. Annual service fees for membership and group subscriptions, and related products and services are set at the prevailing rates, are subject to change and automatically renew from year-to-year unless notice of cancellation in writing is given at least 30 days in advance of the annual subscription renewal date. BCI offers no refunds, including fees for unused services. I understand that my company: is responsible for all BCI charges incurred by employee company's representatives and any amount past due is subject to a monthly 1.5% finance charge. will pay interest or late charges on all unpaid invoices for products and services for the date due until all sums are paid in full, at the lesser of one and one half percent (1-1/2%) per month, compounded monthly, or at the highest contract rate allowed by law, and, is responsible for all costs of collections, before and after judgment, including but not limited to court costs, interest and reasonable attorney fees, should legal action be necessary. Required Response: I agree to the Terms & Conditions and understand due to BCI's advanced venue commitments, no refunds will be made. BCI will honor delegate substitutions upon request.* Yes No Signature / Title*Date* If you do not see a "Submit" button, please agree to the above terms and conditions. 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