Rhode Island Regional Meeting
Registration Form

Crowne Plaza at the Crossings
Warwick, Rhode Island

Check in 3:00 p.m. / Check out 11:00 a.m.

Wednesday, April 9th & Thursday, April 10th

Regional Meeting Registration Fee is $150.00 per person.

If you prefer to fax (401-823-5540) your registration form(s), please click here to download the registration form.

All registrations are automatically charged to your agency account following the regional meeting.
If you would like to pay the registration fee with Arpin Dollars, please mail the Arpin Dollars to Kathy Frazier's attention at the corporate office prior to the meeting
(note: Arpin Dollars may be used for the regional meeting registration fees only).

If you pre-registered for the Regional Meeting during our 2007 Annual Agent Convention, your Regional Meeting registration fee is $125.00 per person.
If you haven't pre-registered for the Regional Meeting and you register by February 1st, you will save $25.00 per agency for the Regional Meeting.
All persons attending the regional meetings and activities must register.

Rhode Island Regional Meeting Registration Deadline - March 1st
We have a limited number of rooms at the Crowne Plaza at the Crossings at our special regional meeting rate of $122.00/night single or double occupancy. Hotel registrations are available on a first come, first served basis only so early registration is strongly advised.

CANCELLATION POLICY: Cancellations must be emailed (kfrazier@arpin.com) or faxed in (401-823-5540) no later than March 1st. Cancellations received after March 1, 2008 are subject to 100% of the regular registration fee, or $150.00/person.

Regional Meeting Registration Information

Agency Name (required):

Email Address (required):
Agency Account Number:

Phone Number:

Please list the first and last names of all attendees:

Hotel Room #1

Name(s)
Check In Date
Check Out Date

Credit Card
Information

 Type:   
Card Number:   
Expiration Date (MM/YY):
Card Holder Name
Card Holder Phone Number
Additional Requirements

Hotel Room #2
Name(s)
Check In Date
Check Out Date
Credit Card
Information
Type:   
Card Number:   
Expiration Date (MM/YY):
Card Holder Name
Card Holder Phone Number
Additional Requirements


Hotel Room #3
Name
Check In Date
Check Out Date
Credit Card
Information
Type:   
Card Number:   
Expiration Date (MM/YY):
Card Holder Name
Card Holder Phone Number
Additional Requirements