Event Information

2012 TPA University
July 10 - 12, 2013
Coeur d’ Alene Resort
Coeur d’Alene, ID

Registrant Information


First Name:


Last Name:


Name to Appear on Badge:


Title:


Company:


Phone:


Fax:


Email Address:


Street Address:


City / State / Zip:


Company Information


Company Type:


If Other, please list:

Registration Fees

All Non Member TPA firms that register to attend this event will receive a complimentary one-year membership to HCAA.

Rates per person: before Friday, June 17th
$500 - HCAA Member TPAs
$400 - Additional HCAA Member TPA
$850 - HCAA Member, but non TPA
$800 - Additional HCAA Member, but non TPA
$850 - Non-Member TPA
- Non-Member, non TPA Not Available

Rates per person: after Friday, June 17th
$600 - HCAA Member TPAs
$500 - Additional HCAA Member TPA
$950 - HCAA Member, but non TPA
$900 - Additional HCAA Member, but non TPA
$950 - Non-Member TPA
- Non-Member, non TPA Not Available


Please include a list of all attendees:
First and last name for badge, title, and email address,
please note if attendee is a first time attendee


Payment Information


Payment Type:
If you selected a Credit Card as your payment type, complete the rest of the form below. Otherwise, click "Submit Registration" to proceed.

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Total to Charge: $ .00
Add up registration fees for all those attending and put total in the box above. This is the amount that will get charged to the card entered below.

Name on Credit Card:


Account Number:


Exp. Date:
(ie: MM / YY)

Card Code (CVV):
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Billing Zip Code:



Cancellation/Transfer Policy: All requests must be in writing. A $50 administrative fee will be made for cancellations received at least 10 business days prior to the program. No refund will be issued for cancellations received later than 10 business days prior to program. Transfer requests must be received at least five business days prior to program.     Click Here TPA University Home
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