LOMA Event Registration - Columbus

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 $40.00 (Regular Member) or $50 Guest Registration to LOMA Society of Ohio: By Mail At the Door All In Member (no charge)

By Mail to:
Nationwide Financial
Attention: Amy Burchette
One Nationwide Plaza.
Columbus, OH 43215