Firs
t Cla
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RSRT
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2019 Spring Education ConferenceApril 6, 2019 • Los Angeles, CA
May 4, 2019 • Walnut Creek, CA
REGISTRATION FORMNote: One registrant per form. Photocopies may be used.o Los Angeles: April 6, 2019o Walnut Creek: May 4, 2019
Bar Number: _________________________________________________________________
Name: _______________________________________________________________________
Firm: _________________________________________________________________________
Firm Address: _________________________________________________________________
City, State:_____________________________________________ Zip Code: ____________
Phone Number: ______________________________________________________________
Email Address: ________________________________________________________________
Program package includes 6 hours of MCLE and legal specialization credits, program materials, continental breakfast and lunch.
Check here if you do not want your information released.This event may be recorded. By attending this event, you consent to be photographed, filmed, and/or otherwise recorded, and to any use, by the CLA, of your likeness, voice, and name in any and all media including social media. If you do not want your name or photo to be used, please let us know in advance. We cannot, however, honor requests to opt out of the use of your image or voice if you choose to ask a question during one of the event sessions.
PRE-REGISTRATION FEES (check the appropriate circle)o $295 Workers’ Compensation Section Members o $390 Non-Section Members (includes enrollment in the Workers’ Compensation Section for 2019)o $195 Claims Specialist **Onsite registration fees are $345 for Section Members and $440 for Non-Section MembersAMOUNT ENCLOSED OR TO BE CHARGED $____________
REGISTRATION INFORMATIONDeadline: In order to pre-register, your form and check, payable to
California Lawyers Association, or credit card information, must be received by 5 days prior to the program.
Register Online: http://CAlawyers.org/WorkersCompMail To: Program Registrations, California Lawyers Association
400 Capitol Mall, Suite 650, Sacramento, CA 95814Email To: Program Registrations at [email protected]. In
order to email your registration, credit card information is MANDATORY. (Photocopies of checks will NOT be accepted.)
CREDIT CARD INFORMATION (VISA/MASTERCARD ONLY)I authorize California Lawyers Association to charge my program registration to my VISA/MasterCard account. (No other credit card will be accepted.)
Account Number: ____________________________________________________________
Expiration Date: ______________________________________________________________
Cardholder’s Name: __________________________________________________________
Cardholder’s Signature: _______________________________________________________
(Required for email confirmation)
(VISA or MasterCard only)
California Lawyers Association and the Workers’ Compensation Section are approved State Bar of California MCLE providers.
R e g i s t e r O n l i n e h t t p : / / C A l a w y e r s . o r g / W o r k e r s C o m p
CA
LIFO
RNIA
LAW
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ASS
OC
IATIO
N
Wor
kers
’ Com
pens
atio
n Se
ctio
n 40
0 C
apito
l Mal
l, Su
ite 6
50Sa
cram
ento
, CA
958
14
2019
Spr
ing
Ed
ucat
ion
Con
fere
nce
APR
IL 6
, 201
9W
ESTIN
BO
NAVE
NTUR
E HO
TEL
& SU
ITES
404
S. F
igue
roa
Stre
etLo
s Ang
eles
, CA
900
71
MA
Y 4,
201
9W
ALN
UT C
REEK
M
ARR
IOTT
355
N. M
ain
Stre
etW
alnu
t Cre
ek, C
A 9
4596
Earn
6 H
ours
MC
LE C
red
it
REG
ISTE
R O
NLI
NE:
http
://C
Ala
wye
rs.o
rg/W
orke
rsC
omp
Earn 6
Hours MCLE Credit
Includes Legal
Specialization Credits
CALIFORNIA LAWYERS ASSOCIATIONWORKERS’ COMPENSATION SECTION
APRIL 6, 2019Westin Bonaventure Hotel & Suites404 S. Figueroa StreetLos Angeles, CA 90071
MAY 4, 2019Walnut Creek Marriott355 N. Main StreetWalnut Creek, CA 94596
Register Online: http://CAlawyers.org/WorkersComp
2019 Spring Education Conference
Firs
t Cla
ss P
RSRT
Mai
lU.
S. P
OST
AG
EPA
IDD
ocum
atio
n
2019 Spring Education ConferenceApril 6, 2019 • Los Angeles, CA
May 4, 2019 • Walnut Creek, CA
REGISTRATION FORMNote: One registrant per form. Photocopies may be used.o Los Angeles: April 6, 2019o Walnut Creek: May 4, 2019
Bar Number: _________________________________________________________________
Name: _______________________________________________________________________
Firm: _________________________________________________________________________
Firm Address: _________________________________________________________________
City, State:_____________________________________________ Zip Code: ____________
Phone Number: ______________________________________________________________
Email Address: ________________________________________________________________
Program package includes 6 hours of MCLE and legal specialization credits, program materials, continental breakfast and lunch.
Check here if you do not want your information released.This event may be recorded. By attending this event, you consent to be photographed, filmed, and/or otherwise recorded, and to any use, by the CLA, of your likeness, voice, and name in any and all media including social media. If you do not want your name or photo to be used, please let us know in advance. We cannot, however, honor requests to opt out of the use of your image or voice if you choose to ask a question during one of the event sessions.
PRE-REGISTRATION FEES (check the appropriate circle)o $295 Workers’ Compensation Section Members o $390 Non-Section Members (includes enrollment in the Workers’ Compensation Section for 2019)o $195 Claims Specialist **Onsite registration fees are $345 for Section Members and $440 for Non-Section MembersAMOUNT ENCLOSED OR TO BE CHARGED $____________
REGISTRATION INFORMATIONDeadline: In order to pre-register, your form and check, payable to
California Lawyers Association, or credit card information, must be received by 5 days prior to the program.
Register Online: http://CAlawyers.org/WorkersCompMail To: Program Registrations, California Lawyers Association
400 Capitol Mall, Suite 650, Sacramento, CA 95814Email To: Program Registrations at [email protected]. In
order to email your registration, credit card information is MANDATORY. (Photocopies of checks will NOT be accepted.)
CREDIT CARD INFORMATION (VISA/MASTERCARD ONLY)I authorize California Lawyers Association to charge my program registration to my VISA/MasterCard account. (No other credit card will be accepted.)
Account Number: ____________________________________________________________
Expiration Date: ______________________________________________________________
Cardholder’s Name: __________________________________________________________
Cardholder’s Signature: _______________________________________________________
(Required for email confirmation)
(VISA or MasterCard only)
California Lawyers Association and the Workers’ Compensation Section are approved State Bar of California MCLE providers.
R e g i s t e r O n l i n e h t t p : / / C A l a w y e r s . o r g / W o r k e r s C o m p
CA
LIFO
RNIA
LAW
YERS
ASS
OC
IATIO
N
Wor
kers
’ Com
pens
atio
n Se
ctio
n 40
0 C
apito
l Mal
l, Su
ite 6
50Sa
cram
ento
, CA
958
14
2019
Spr
ing
Ed
ucat
ion
Con
fere
nce
APR
IL 6
, 201
9W
ESTIN
BO
NAVE
NTUR
E HO
TEL
& SU
ITES
404
S. F
igue
roa
Stre
etLo
s Ang
eles
, CA
900
71
MA
Y 4,
201
9W
ALN
UT C
REEK
M
ARR
IOTT
355
N. M
ain
Stre
etW
alnu
t Cre
ek, C
A 9
4596
Earn
6 H
ours
MC
LE C
red
it
REG
ISTE
R O
NLI
NE:
http
://C
Ala
wye
rs.o
rg/W
orke
rsC
omp
Earn 6
Hours MCLE Credit
Includes Legal
Specialization Credits
CALIFORNIA LAWYERS ASSOCIATIONWORKERS’ COMPENSATION SECTION
APRIL 6, 2019Westin Bonaventure Hotel & Suites404 S. Figueroa StreetLos Angeles, CA 90071
MAY 4, 2019Walnut Creek Marriott355 N. Main StreetWalnut Creek, CA 94596
Register Online: http://CAlawyers.org/WorkersComp
2019 Spring Education Conference