2009 Industrial Sector Conference Registration

July 21-23, 2009
Kansas City, Missouri

Registration Form

Instructions: Complete one form for each officer who will attend the conference. All registrations must be completed, signed, and submitted, FAXed or mailed to the Industrial Sector Services Department by the registration deadline of June 15, 2009.

Registration Form

If mailing, please download the PDF form above, complete, sign and mail to

International Brotherhood of Boilermakers
Industrial Sector Services Department
Attn. Erica Turney
753 State Ave, Suite 570
Kansas City, KS 66101.

If FAXing, please download the PDF form above, complete, sign and FAX to 913-281-8104, ATTN: Erica Turney

(* denotes required fields.)

First Name*

Last Name*

Nickname (optional)

Street Address*

City*

State/Province*

Zip/Postal Code*

Telephone*

Format(###-###-####)

Email Address*

Local Lodge No.*

Current Office in Lodge*

Local Lodge Officer authorizing this person to attend*

Will you be staying at this hotel?*
(You must make your own hotel reservations.)

Yes No

Are you sharing a room with someone else attending this training?*

Yes No

REGISTRATION DEADLINE - June 15, 2009

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