Registration Form Each attendee must complete the registration individually. If you are paying online, the transaction must be done for each attendee separately. REGISTRANT INFORMATION First Name: * Last Name: * Name as should appear on badge: * Address: * City: * Zip Code: * Phone: * Email Address: * REGISTRATION FEE PAYMENT OPTIONS If you wish to pay online by credit card, please click the PAY ONLINE button below. Otherwise, please click the PAY AT DOOR button to complete your registration. ONLY cash, checks, or POs will be accepted at the door. Registration Category: * Professional Student State: * Comments/Special Requirements image * All Items Required Please address questions or concerns to Tiffany Collins, 706-778-8500, ext.1497, tcollins@piedmont.edu * Registration Fee: Professional: $40.00, Student: $20.00 (covers all costs).