= Members Only
   Information

Young Agent Complimentary
Convention Registration

PIIAI is offering complimentary convention registration packages for the Convention Showcase, October 3-5, at the Crowne Plaza in Springfield. To be eligible, you must:

  1. Never have attended a previous convention (in full or in part).
  2. Be a young agent (40 years old or younger) employed by a PIIAI member agency.
  3. Plan to attend the PIIAI convention (in full or in part).

Please note that recipients are responsible for their own travel, overnight accommodations, and incidentals.

To be considered, simply complete the form below and submit to PIIAI. If you have additional questions, contact Shannon Churchill at (800) 628-6436, ext. 3004.

Deadline: September 10, 2007

*All fields are required*

Name:
Agency:
Address:
City:
State: Zip:
Phone:
Fax:
Email:

To print of copy of the form (pdf format), click here.