Note: Please verify that the URL "*.ic3.com" is in your Trusted Sites List BEFORE registering for an event.
Instructions for adding a URL to your Trusted Sites list can be found here.

Event Information:
Event Name:
Event Price (U.S. Dollars):
Note: When paying for items other than the standard registration fee
for one person, please change the event price to appropriately
reflect the correct charge.

All fields are required EXCEPT as noted*




Billing Information:
First Name: (as it appears on your credit card)  
Last Name: (as it appears on your credit card)  
Address:
City:
State: (Select N/A if NOT United States, Canada or Puerto Rico)
Zip Code:
Country:
*Invoice No.:
*License No.:
Describe your reason for an Exception Payment, Special Accomodations, or Dietary Requirements (if applicable) for the event you are attending
*Comments:
Attendee(s) Information:
Event Attendee(s): Please list all attendees.
First Name:  
Last Name:
Phone Number:
E-mail:
Business Affiliation:
Payment Information:
Credit Card Type:
Card Number: (no spaces or dashes)
Expiration:  / 
*Card Verification (CV): Value (3 or 4 digit number)
CV number service requested and supported  

Click only ONCE on the "Charge My Card" button.
If you click more than once, your card will be charged multiple times!
PLEASE DO NOT CLOSE THE WINDOW before receiving your receipt.
If you do not receive a receipt, DO NOT CLICK THE BACK BUTTON.
Please contact Cindy Lucero at (505) 844-5636.