SEBC MEMBERSHIP RENEWAL
	Use this form to renew your membership in the SEBC. To assure your listing in the next Membership Directory (to be published and updated on-line), please provide the information requested below. Alternatively to using this on-line form, if you wish to renew your membership by mailing in a printed application along with a check please or credit card information please use the Printable Membership Renewal Form.   *Required Information Professional Information Name*: Title: Business Mailing Address Address1 :* Address2: City:* State:* Zip:* Phone:* (xxx) xxx-xxxx Fax: (xxx) xxx-xxxx Email: Employer:* Industry Discipline* Please select appropriate discipline: ACCOUNTANT INSURANCE PLAN SPONSER Health/Welfare Administrator ADMINISTRATOR (TPA) Retirement Plans Finance Health/Welfare Both Investments Retirement Plans Other Legal Both Management   Other     CONSULTANT INVESTMENTS ATTORNEY Actuary Client Services Health/Welfare Consultant TRUST Management Investment Banker Administration Retirement Plans Marketing Marketing Other Portfolio Manager Other Trust Other Expertise:* Retirement Plans Health & Welfare Both Annual membership dues for the Southern Employee Benefits Conference is US $250. Please be sure all professional information is completed above. As a member of the SEBC, I agree to receive periodic emails from the Southern Employee Benefits Conference. Please view our Privacy Statement and Refund Statement before submitting your registration. Credit Card Number: * Security Code: * (3 digits on back of MC/Visa; 4 digits on front of Amex) Expiration Date: * -- 01 02 03 04 05 06 07 08 09 10 11 12 / ---- 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Card Holder First Name: * Card Holder Last Name: * Any questions should be directed to the Executive Director at the address below. Anne McKillips Southern Employee Benefits Conference 3334 Peachtree Rd. NE Suite 709 Atlanta, GA 30326 Phone: (404) 812-9132 Fax: (404) 240-0158 E-mail address: amckillips@sebc.org Back to Membership page