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TRANSCRIPT
PRINT CLEARLY | USE ONE FORM PER REGISTRANT
PIHRA MEMBER ID ____________________________________________________________
NAME ________________________________________________________________________
CERTIFICATIONS aPHR aPHRi PHR PHRca PHRi
SPHR SPHRi GPHR SHRM-CP SHRM-SCP Other ____________
TITLE ________________________________________________________________________
COMPANY ____________________________________________________________________
ADDRESS ____________________________________________________________________
CITY __________________________________ STATE ______ ZIP ______________________
PHONE _______________________ EMAIL _________________________________________
WHICH LOCATION WOULD YOU LIKE TO ATTEND? TIME: 7:15am – 4:30pm
1/23 La Jolla 1/22 Riverside
REGISTRATION OPTIONS
1/28 Anaheim 1/30 Burbank
AFTER 1/07/20
$249 $279 $299 $162 $182 $195
$299 $329 $349
PIHRA MEMBER PIHRA MEMBER IN TRANSITION OTHER HR ASSOCIATION MEMBER* NONMEMBER**NONMEMBER IN TRANSITION**
*Other HR Association – MUST provide name of HR Association _____________________**Nonmember registrations include a 12-month membership with PIHRA
FOOD ALLERGIES OR DIETARY NEEDS
GLUTEN FREE VEGETARIAN
SPECIAL OFFERS PIHRA MEMBER RENEWAL (must be current PIHRA member) ADD $125
2020 CALCHAMBER LABOR LAW DIGEST 2020 PIHRA LEGAL UPDATE ON DEMAND ADD $119 DIGITAL COPY HARD COPY MEMBER PRICE ADD $59 NONMEMBER PRICE ADD $79
TOTAL DUE: $____________________
PAYMENT INFORMATION | PAYMENT IS DUE AT TIME OF REGISTRATION
I PREFER TO PAY BY CHECK | PAYABLE TO PIHRA | PIHRA TAX ID #95-2222999
I AUTHORIZE PIHRA TO CHARGE MY: VISA MASTERCARD AMEX DISCOVER
CARD# ____________________________________________________ EXP DATE: __________________
NAME ON CARD _________________________________________________________________________
CARDHOLDER SIGNATURE _______________________________________________________________
HOW TO REGISTER
Online: pihra.org/legalupdate
Fax: 310-416-9055
Mail: PIHRA 1515 W 190th St, Ste 530 Gardena, CA 90248
BY 1/07/20
$399$312
$429 $332
BY 10/31/19
$449$345
HOW DID YOU HEAR ABOUT THIS EVENT?
Previous attendee PIHRA Chapter meeting Search engine Advertisement
Receive an email Friend or colleague Letter in the mail
IS THIS YOUR FIRST TIME ATTENDING A PIHRA LEGAL UPDATE SEMINAR?
YES NO
ARE YOU A MEMBER OF:
None SHRM NHRA CalChamber NAAAHR NCHRA Other HR Association _________________
PLEASE IDENTIFY YOUR TYPE OF BUSINESS/INDUSTRY:
Advertising/Marketing Aerospace Agriculture/Forestry Arts/Entertainment/Recreation
Biotech/Pharmaceutical Communication Construction/Engineer Consulting
Consumer Services Education Finance Government
Health/Healthcare Hospitality Insurance Legal
Manufacturing Nonprofit Oil & Gas Public Administration
Publishing/Printing Real Estate Restaurant/Food Services Staffing
Technology Transportation Utilities/Energy Warehouse
Wholesale/Retail Other
YOUR COMPANY SIZE:
1 – 9 10 – 49 50 – 99 100 – 499 500 – 999 1000+
YEARS IN HR:
0 – 4 5 – 9 10 – 14 15+
REGISTRATION TERMS
CANCELLATIONS: Cancellations must be received in writing and faxed to 310-416-9055 or emailed to [email protected]. Fifty percent (50%) of the registration fee will be refunded for cancellations received by 1/17/20. Refunds will not be granted after 1/17/20 nor will they be given for no-shows. Credits will not be issued towards future PIHRA programs.
SUBSTITUTIONS: All substitutions must be submitted in writing and faxed to 310-416-9055 or emailed [email protected] by 1/17/20. All other substitutions will be processed onsite at registration. If a PIHRA member transfers his/her registration to a nonmember, the nonmember must pay the difference of the member and nonmember price or become a PIHRA member at the time of the transfer. Only one substitution allowed per registrant. No split registrations.
ADDITIONAL INFORMATION: Registration and attendance at, or participation in, such programs and events constitutes an agreement by the registrant to our use and distribution (both now and in the future) of the attendee’s image or voice in photographs, videotapes, electronic reproductions and audiotapes of such programs and activities. Nonmember registrations include a one-year PIHRA membership.