WorkCompEvent.com Registration System

SPONSORSHIP OPPORTUNITY
You are invited to register as a sponsor for the 2024 Texas Workers’ Compensation Conference. This includes virtual sponsor listing branded with company logo; brief description of company services; link to company website; sponsors featured in daily welcome video; sponsor logos displayed on the conference app; and one complimentary attendee registration.

Gold Sponsor

$1,000 Contribution

• Sponsors will be featured in the conference app and on the opening conference video.
• One complimentary attendee registration.

Business Name

Contact Person *

First

Last

Specialty

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

Email *

Fax

Conference Exhibitor Fee *

Price: $1,000.00

Attendees

If you have the attendee information for your exhibit, please enter them here.

Attendee 1 Name

Attendee 1 Title

Attendee 1 Email

Attendee 1 Phone

For Continuing Education Credits, Please select all that apply for this attendee:

• Adjuster
• CCM
• CDMS
• CLE
• SHRM
• Safety Professional

Total

$0.00

How would you like to pay? *Please select onePay by CheckCredit Card via Authorize.net

The address you entered above must match that of your CC billing address.

Payment via Authorize.Net *

Card Number

MM123456789101112Expiration

/

YY2425262728293031323334

Security Code

Payment by Check *

• I agree to pay by check

Press register below.

For payment by check, make it payable to IWCF and mail to 570 Memorial Circle, Suite 320, Ormond Beach, FL 32174, along with a note with your name and the name of the Conference, so we credit the payment correctly.

Register

CONFERENCE REGISTRATION
Conference registration includes all sessions and conference materials. Contact IWCF at 386-677-0041 or CompConference@IWCF.us for additional conference registration information. Please submit a separate registration for each conference participant or attendee.

CANCELLATION
Cancellation without notice is subject to full forfeiture of registration fee. Cancellation with notice after 5:00 p.m., October 11, 2024, is subject to a $50 administrative fee.

WHOVA REGISTRATION AND ACCESS
Be sure to provide an accurate, legible, and unique email address when you register to ensure receipt of the instructions to sign in to the conference app to access the sessions and materials. You will need to use this same email address each time you log in. Watch for the instructions and updates via email from CompConference@IWCF.us or from the conference app (Whova.com). Please add CompConference@IWCF.us as a trusted contact for your email software. Please check with your IT department to ensure your browser has access to Whova.com.

Note: Any text, including Q&A and chat, submitted through the conference platform or by email may be captured or broadcast as part of the conference. Unlawful harassment and derogatory comments are not allowed. Recording or broadcasting conference presentations is expressly prohibited.

CONTINUING EDUCATION CREDITS
Applications will be made for up to 8.5 hours of Texas CLE credit for attorneys, TDI continuing education credit for insurance adjusters, SHRM credit for human resources professionals, and CDMS and CCM credits for rehabilitation providers. Adjusters must provide insurance-related license number at the time of registration. Insurance adjusters must attend all sessions each day to receive credit for that day; no partial credit will be given. A certificate of attendance is provided for other professional disciplines.

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For additional information contact the IWCF at:
Phone: 386-677-0041 • Fax: 386-677-0155
Email: compconference@iwcf.us