2022 Region IV IIMC Conference
When completing your information please use the correct sentence case. (Do not type in all caps)
Municipality Name Only (Ex. Starkville)
Are you a new clerk with less than 1 year of experience?
Will you be booking a room at the Sheraton?
Athenian Dialogue $50
Region IV Conference $215
Business Meeting Only
Please indicate any special accommodations you might require?
I understand that if I register for the conference but do not attend, the registration fee is still due and payable if not canceled before the registration deadline.
Gender (For Reporting Purposes Only)
Ethnicity (For Reporting Purposes Only)
Hispanic or Latino
Not Hispanic or Latino
Race (For Reporting Purposes Only)
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander