Please submit the following information First Name Last Name Position/Job Title E-mail Telephone Please provide a phone number where we may call you regarding this request Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Invoicing Information The University of Minnesota will invoice your company if you can't use a credit card to pay for registration. In the fields below, please provide contact information for the person who will process the invoice. The billing contact address must be for a business location. Residential addresses are not allowed. Employer Billing Contact Name Name of the person who will process an invoice Billing Contact Telephone Billing Contact E-mail Billing Contact Address Billing Contact City Billing Contact State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Billing Contact Zip Code Course(s) you plan to attend Discount code, if applicable Enter a discount code if you were provided one. Comments or questions Please let us know if you have any comments or questions about your registration. Did you graduate from the University of Minnesota? - Select -YesNo If Yes, what degree did you receive and what year did you graduate from the University of Minnesota? If you've earned multiple degrees, please list the most recent. Leave this field blank