Loma Event Registration - CINCINNATI

(This is the CINCINNATI event page)

First Name:
Last Name:
Email Address: Email Address Verify:
Company:    if other....
Phone (ex: xxx-xxx-xxxx) :    Extension:

LOMA/LIMRA Designations:
List any new LOMA/LIMRA Designations:

I will pay my $0 if an all-in member / $40.00 if not an all-in member / $50-Guest registration (made payable to LOMA Society of Ohio) : By Mail At the Door
By Mail to.....
Attention: Renee Prevatte - LSO
400 Broadway MS-82
Cincinnati, OH 45202