Revenue ePIF

Ticket Information

Status

The status of the ticket. This indicates where the ticket is in its lifecycle.

Request Information

Select Division

Program Unit Name

Chartfield Spread

Purpose Code

Project Code

Sponsored Program

Activity Title

This will be the name that will be printed out on the certificate/name badges.

Activity Description

Date the Activity Begins

Date the Activity Ends

Facility

Coordinator

Clock Hours

Method of Delivery

City

County

State

County

Max Number of Participants

Registration Fees

Please enter your estimated price and or fee structure for this registration event.

CEUs

Number of CEUs

Online Registration

Will you be offering certificates

Certificate Type

Comments/Special Instructions

Please Check All That Apply

Attendee information will be shared with other attendees, exhibitors & sponsors

Attendee information will be shared with the funding agency

There is a rebate on the rooms which will be credited toward conference expenses

Photographs or videos will be taken at the conference

Additional Information That Needs Collected

Information other than the basic contact information, i.e. T-shirts, Emergency Contact, Special Dietary Needs.

Attachment

File attachments associated with the ticket.

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Your name

Your email address

Verification Code

Revenue ePIF

Ticket Information

Request Information

Sponsored Program

Other Fields