Judiciary Night Registration, 2024 Click here if you wish to sponsor this event. Please enable JavaScript in your browser to complete this form.Name *FirstLastFirm *Email *Phone *Address *Address Line 1City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIf you are registering for the event, are you a current member of QCWBA or are you a member of the judiciary? *YesNoMember TicketsNumber of member tickets1 – $0.002 – $0.003 – $0.004 – $0.005 – $0.006 – $0.00Non-Member TicketsNumber of non-member tickets: In person1 – $75.002 – $150.003 – $225.004 – $300.005 – $375.006 – $450.00Enter the names of attendee(s) below:Attendee 1 *Attendee 2 *Attendee 3 *Attendee 4 *Attendee 5 *Attendee 6 *Total Payment *$0.00PaymentStripe Credit Card *CardName on CardSubmit
