Online Registration

Register below to secure your seat for the conference. An email confirmation will be sent to you immediately confirming your registration. Due to the overwhelming popularity of this event and the limited seating, there will be NO REFUNDS once a confirmation of the purchase is emailed to the registrant.

Attendee Information
 
* Indicates required fields
First Name:
 *
Last Name:
  *
Title:
Company:
Address:
  *
City State Zip:
  *
Phone:
  * ( Format: 555-555-5555 )
Email:
  *
Billing Address is the Same as Above
Billing Address:
  *
Billing City State Zip:
  *
   
Seminar Information

Registration Fee. ($125)
 
Meal Selection

Salad with broiled chicken

Salad with broiled salmon
 
Scholarship Program

Yes, I would like to contribute to the WOW! Forum Scholarship Program. Four (4) scholarships to attend the conference will be awarded. 

  $5    $10    $15  or other amount $
 

Payment Information (via secure connection). Payments are non-refundable.

Your registration fee includes a Continental Breakfast, Speakers, Luncheon, Networking Reception with Silent Auction and Free Parking.

I have received a Sponsor/Promotional code.

Sponsor/Promo Code: 

   

I will be paying by check.
Checks must be received by the NW CT Chamber of Commerce within five (5) business days from the day of registration to avoid cancellation.

Make Checks Payable To:

Northwest Connecticut's Chamber
333 Kennedy Drive, Suite R101, P.O. Box 59
Torrington, CT 06790

I will be paying by credit card.

A $4.00 service fee will be added to all credit card orders.
Card Type            *
Card Number
*  (no spaces)
Exp Date
*   (MM/YY)
CVC Code
 (3 digit code found on back of card)
  random imagePlease enter the numbers/letters in the picture to the left in the box below.
Validation :
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