Breakthrough Registration Contact Information Name Job Title Company Email Phone Conference Registration Which conference track(s) are you most interested in attending? Revenue ManagementContract Management (UCM)Policy Management (PolicyStat)Policy Management (PolicyMedical) Number of Registrations: —Please choose an option—12345678910 List Name,Title & Email for all registrants 3-Day Conference Pass includes Pre-Conference Training Session - $1,650.00 Registration includes: • One Pre-conference Training Session held on Wednesday, June 5th • Conference Sessions held on Thursday, June 6th & Friday, June 7th • Conference Kickoff Welcome Mixer • Networking meals, breakfast & lunch included and off-site dinner event on Thursday, June 6th 2-Day Conference Pass - $1,250.00 • Conference Sessions held on Thursday, June 6th & Friday, June 7th • Conference Kickoff Welcome Mixer • Networking meals, breakfast & lunch included and off-site dinner event on Thursday, June 6th Select Conference Option: —Please choose an option—3-Day Conference Pass - $16502-Day Conference Pass - $1250 Select Training Session (only for 3-Day Conf Pass): —Please choose an option—RM Commercial SolutionsRM Govt Pricing SolutionsUCM Admin RefresherPolicyStat BootcampPolicyMedical BootcampNo Training (2-Day Pass) Terms Registration Payment Terms: Checks are payable to iContracts. Credit card payments accepted. Hotel Accommodations: Hotel accommodations are not included in the registration fee. Cancellations/Substitutions: You may send a substitute in your place with prior written notice of such substitution. Cancellations must be in writing. A cancellation fee equal to 50% of the registration fee will be charged for any cancellations made after May 5, 2019. If you have to cancel your participation in the event, please notify us as soon as possible by email: breakthrough@icontracts.com. Payment Options Invoice If you would like iContracts to invoice your company, please select "Invoice" and press the submit button. You will receive an invoice within 24 - 48 hours after submitting the registration form. Pay by Credit Card If you would like to pay by credit card, please select "PayPal" and press the submit payment button. You will be redirected to our PayPal merchant account to finalize payment. *Please note, you do not need a PayPal account to submit your payment. Select Payment Type —Please choose an option—PayPalInvoice *Do not refresh browser after clicking the Submit button. If paying by credit card, you will be redirected to PayPal within 10 seconds. Questions/Contact: Kristen Abrahamsen kabrahamsen@icontracts.com 908.450.9277