When: Thursday, November 13, 2003

Your registration form must be received by: November 7, 2003

Where: Hotel Fort Des Moines
10th & Walnut
Des Moines, Iowa

Reduced parking rates available at 10th & Walnut with entrance on 10th St.

Cost: $50  Seminar & Lunch / $35  Seminar Only / $23  Lunch Only Full refunds granted prior to November 7, 2003

 

Registration Form  (Click here for a printer friendly window)

Name(s):  

 

Company / Agency:  

 

Address:

 

 

Telephone:

 

 

In order to have an accurate count;
please call, fax, or e-mail reservations by
November 7, 2003 to:

Wade E. Sheeler, CPCU, CIC
Phone: 641-269-8565
Fax: 641-236-2838
E-mail: iowacpcu@gmrc.com

______ Seminar & Recognition Luncheon $50

______ Seminar Only $35

______ Luncheon Only $23

Make check payable to:
Iowa Chapter — CPCU

Send check to:
Wade E. Sheeler, CPCU, CIC
Grinnell Mutual Group
4215 Hwy. 146
P.O. Box 790
Grinnell, IA 50112-0790

Registration Form must be received by November 7, 2003