Please submit this entire page for your registration. For multiple registrations, please duplicate this form.

Mail To:

Registration Services
The University of Alabama
Box 870388
Tuscaloosa, AL 35487

Which event are you attending?

[  ] In-person:  Fall 300 Level Training Institute CS-2410-ROSI01-01: October 16-18, 2024, Bryant Conference Center, Early Bird Registration Fee- $235 (ends September 27, 2024),
[  ] Live-Stream:  Fall 300 Revenue 300 Level Training Institute CS-2410-ROSI01-02: October 16-18, 2024, Live via Zoom, Early Bird Registration fee- $235 (ends September 27, 2024)

Which credential do you need?

[  ] Currently seeking CMRO – Certified Municipal Revenue Officer Certification
[  ] Seeking 10 hours CMRO Maintenance
[  ] Seeking 20 hours CMRO Maintenance
[  ] Seeking 20 hours CRE Maintenance

[ ]Mr. [ ]Ms. [ ]Dr. First:____________________________Middle Initial:________Last:____________________________

Preferred Name/Nickname:____________________________

Company/Organization Name:____________________________

Mailing Address:____________________________City:____________________________State:________Zip:______________

Email Address:____________________________Phone:____________________________

Job Title:____________________________

[ ] Enclosed is a check for $____________________________ made payable to THE UNIVERSITY OF ALABAMA

[ ] Purchase order is attached.

[ ] Charge $____________________________to credit card: [ ] MasterCard [ ] VISA [ ] American Express [ ] Discover

Card #____________________________Exp. Date (M/Y)____________________________

Security / Verification / CVV Code____________________________(Three or four digit code on back or front of credit card.)

Authorizing Signature:____________________________

A cancellation charge of 100% of the registration fee will be assessed on cancellations occurring within seven (7) days of the start of this session. Refunds will not be granted after the program has begun. The University of Alabama reserves the right to cancel, postpone or combine class sections, to limit registration or to change instructors. To cancel your registration, contact the Registration Services department at 205-348-3000 or registration_services@ua.edu. View the OTIDE Cancellation Policy online.