12I Compliance Agent (In-Service Online)

Sunday, February 16, 2025

Please complete the following. You will be given an opportunity to confirm all of the data that you enter. An asterisk(*) indicates that a field is required.
 
Personal Information
The way you enter your name here will be the way your name appears on all event information (name tags, certificates, rosters, etc.).
 
(Mr., Mrs., Dr., etc.)
:
Organization*: