Skip to content
Developed by Cainellsworth |
cainellsworth.com
Search for:
Meet the Team
Academy Details
Register for 2020
Login
Search for:
Meet the Team
Academy Details
Register for 2020
Login
Meet the Team
Academy Details
Register for 2020
Login
Full Registration
Home
/
Full Registration
Full Registration
user
2020-08-28T11:02:29-05:00
You can mail in your registration by printing the form below.
Download the registration from
Please use the registration form below to get started today!
Step 1 of 6 - Basic Entry Info
16%
Name
*
First
Last
Bank
*
Title/Position
*
Email
*
Website
*
Address
*
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Business Phone
*
Cell Phone
*
Bio Information
Brief Bio
*
Brief bio (under 100 words) OR fill in the fields below and we will create a bio based on your information. This bio will be used in the participant directory available to all Academy participants.
Professional Designations
*
Education
*
Background in banking
*
Hobbies/Interests/Family
*
Conference Information
Will you attend the annual conference?
*
This will serve as your registration for the annual conference. You are responsible for hotel and travel arrangements. We strongly recommend that all participants attend the annual conference.
Registration is limited.
Yes, register me for the annual conference · January 28‐29, 2021 · To Be Determined, USA
No, I am unable to attend the conference
Guide Information
If you do not yet have a guide, please leave these areas blank and inform us when you have identified the individual. The first guide webinar is scheduled for Wednesday, October 7, 2020.
Name
First
Last
Email
Years at bank
Position/title
Guide Address
Address is same as above
Guide Address
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Administrative contact
This is the primary contact at the bank for billing or other administrative purposes (optional).
Name
First
Last
Email
Position/title
Admin Address
Address is same as above
Guide Address
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Pricing Information
Three annual payments of $3,600 due by August 15, 2020, 2021, and 2022. ($3,850 if registering after August 15)
Payment Information
*
Check
Invoice me
Credit card
Please make check payable to Cain Ellsworth & Company, LLP, 1008 3rd Avenue, Sheldon, IA 51201 or to pay by credit card, contact our office at (712) 324‐4614 or
[email protected]
Application Process:
Please email this form along with a photo (head and shoulders only) to
[email protected]
The photo will be used in the participant bio and should be printable at a minimum of 2 x 2.75 inches (or 400 x 550px).
Cancellation Process:
Participants will be refunded their registration fee in full if we are notified of their withdrawal in writing by September 1, 2020. After this date, participants will be eligible for a prorated refund of their registration fee.