*
Questions marked with an asterisk (*) are mandatory.

Unemployment Insurance Basics

Registration Form

Tuesday, October 20, 2009
8:30 to 12:00 pm
Registration and continental breakfast begin at 8:00

Golden Valley Golf & Country Club
7001 Golden Valley Road
Golden Valley, MN 55427

This seminar is brought to you by RJF Agencies and the Unemployment Insurance Division of the MN Department of Employment and Economic Development. 
1

* Please provide us with your contact information:
* Name: 
Company: 
* Address: 
 
* City: 
* State:   * Zip:  
2

* Please provide us with your e-mail address:
3

* Are you an RJF client?
Yes
No
4

How did you hear about this seminar?
5

* The registration fee for this seminar is $20.00 for the first person and $10.00 for each additional person from my company.  By clicking below I understand that RJF Agencies will bill me for this seminar.
Yes
6

Please list additional attendees from your company:
Name #1
Name #2
Name #3
Name #4
Name #5
Name #6

If you would like to register more than six attendees from your company or if you have any questions regarding registration or the seminar, please contact Connie Pittelkow at pittelkowc@rjfagencies.com or 763-746-8261.