Conference Group Registration

2025 Conference Event Group Registration

Group registration for the 2025 Annual Anti-Fraud Conference

"* (required)" indicates required fields

Step 1 of 3

For every five paid conference registrations from a business entity or government agency, a sixth conference registration is complimentary. Contact the AFA Executive Secretary ([email protected]) for a discount code.

Group Registration Coordinator Details

Registration Coordinator Name* (required)

Prefix First Last

Coordinator Title* (required)

Coordinator Email* (required)

For verification please provide your professional email address.

Enter Email Confirm Email

Coordinator Phone* (required)

Please enter your professional/org phone

Organizational Details

Organization Category* (required)

ASSOCIATION* (required)

Organizational Concentration, Area of Focus or Specialty

CARRIER* (required)

Organizational Concentration, Area of Focus or Specialty

LAW FIRM* (required)

Organizational Concentration, Area of Focus or Specialty

PRIVATE INVESTIGATOR FIRM* (required)

Organizational Concentration, Area of Focus or Specialty

PUBLIC SECTOR* (required)

Organizational Concentration, Area of Focus or Specialty

SELF-INSURED* (required)

Organizational Concentration, Area of Focus or Specialty

SERVICE PROVIDER* (required)

Organizational Concentration, Area of Focus or Specialty

THIRD PARTY ADMINISTRATOR* (required)

Organizational Concentration, Area of Focus or Specialty

Organization Name* (required)

Organization Name – OTHER

Organization Address Region* (required)

United States

Canada

All Other Int’l

Organization Address – United States* (required)

Street Address City State ZIP Code

Organization Address – Canada* (required)

Street Address City Province Postal Code

Organization Address – International* (required)

Street Address City State / Province / Region ZIP / Postal Code Country

Registrant Details

Number of Registrations

Registrant 1

1. Name* (required)

First Last

1. Optional: Preferred First and Last Name for Conference Badge

1. Professional Title* (required)

Will appear on Conference Badge / Do not include organization name

1. Email* (required)

1. Primary Phone* (required)

1. Please enter your P.O.S.T number (if applicable)

1. Please enter your California State Bar number (if applicable)

1. Membership Registration Status* (required)

Registrant 2

2. Name* (required)

First Last

2. Optional: Preferred First and Last Name for Conference Badge

2. Professional Title* (required)

2. Email* (required)

2. Primary Phone* (required)

2. Please enter your P.O.S.T number (if applicable)

2. Please enter your California State Bar number (if applicable)

2. Membership Registration Status* (required)

Registrant 3

3. Name* (required)

First Last

3. Optional: Preferred First and Last Name for Conference Badge

3. Professional Title* (required)

3. Email* (required)

3. Primary Phone* (required)

3. Please enter your P.O.S.T number (if applicable)

3. Please enter your California State Bar number (if applicable)

3. Membership Registration Status* (required)

Registrant 4

4. Name* (required)

First Last

4. Optional: Preferred First and Last Name for Conference Badge

4. Professional Title* (required)

4. Email* (required)

4. Primary Phone* (required)

4. Please enter your P.O.S.T number (if applicable)

4. Please enter your California State Bar number (if applicable)

4. Membership Registration Status* (required)

Registrant 5

5. Name* (required)

First Last

5. Optional: Preferred First and Last Name for Conference Badge

5. Professional Title* (required)

5. Email* (required)

5. Primary Phone* (required)

5. Please enter your P.O.S.T number (if applicable)

5. Please enter your California State Bar number (if applicable)

5. Membership Registration Status* (required)

Registrant 6

6. Name* (required)

First Last

6. Optional: Preferred First and Last Name for Conference Badge

6. Professional Title* (required)

6. Email* (required)

6. Primary Phone* (required)

6. Please enter your P.O.S.T number (if applicable)

6. Please enter your California State Bar number (if applicable)

6. Membership Registration Status* (required)

Registrant 7

7. Name* (required)

First Last

7. Optional: Preferred First and Last Name for Conference Badge

7. Professional Title* (required)

7. Email* (required)

7. Primary Phone* (required)

7. Please enter your P.O.S.T number (if applicable)

7. Please enter your California State Bar number (if applicable)

7. Membership Registration Status* (required)

Registrant 8

8. Name* (required)

First Last

8. Optional: Preferred First and Last Name for Conference Badge

8. Professional Title* (required)

8. Email* (required)

8. Primary Phone* (required)

8. Please enter your P.O.S.T number (if applicable)

8. Please enter your California State Bar number (if applicable)

8. Membership Registration Status* (required)

Registrant 9

9. Name* (required)

First Last

9. Optional: Preferred First and Last Name for Conference Badge

9. Professional Title* (required)

9. Email* (required)

9. Primary Phone* (required)

9. Please enter your P.O.S.T number (if applicable)

9. Please enter your California State Bar number (if applicable)

9. Membership Registration Status* (required)

Registrant 10

10. Name* (required)

First Last

10. Optional: Preferred First and Last Name for Conference Badge

10. Professional Title* (required)

10. Email* (required)

10. Primary Phone* (required)

10. Please enter your P.O.S.T number (if applicable)

10. Please enter your California State Bar number (if applicable)

10. Membership Registration Status* (required)

Registrant 11

11. Name* (required)

First Last

11. Optional: Preferred First and Last Name for Conference Badge

11. Professional Title* (required)

11. Email* (required)

11. Primary Phone* (required)

11. Please enter your P.O.S.T number (if applicable)

11. Please enter your California State Bar number (if applicable)

11. Membership Registration Status* (required)

Registrant 12

12. Name* (required)

First Last

12. Optional: Preferred First and Last Name for Conference Badge

12. Professional Title* (required)

12. Email* (required)

12. Primary Phone* (required)

12. Please enter your P.O.S.T number (if applicable)

12. Please enter your California State Bar number (if applicable)

12. Membership Registration Status* (required)

Registrant 13

13. Name* (required)

First Last

13. Optional: Preferred First and Last Name for Conference Badge

13. Professional Title* (required)

13. Email* (required)

13. Primary Phone* (required)

13. Please enter your P.O.S.T number (if applicable)

13. Please enter your California State Bar number (if applicable)

13. Membership Registration Status* (required)

Registrant 14

14. Name* (required)

First Last

14. Optional: Preferred First and Last Name for Conference Badge

14. Professional Title* (required)

14. Email* (required)

14. Primary Phone* (required)

14. Please enter your P.O.S.T number (if applicable)

14. Please enter your California State Bar number (if applicable)

14. Membership Registration Status* (required)

Registrant 15

15. Name* (required)

First Last

15. Optional: Preferred First and Last Name for Conference Badge

15. Professional Title* (required)

15. Email* (required)

15. Primary Phone* (required)

15. Please enter your P.O.S.T number (if applicable)

15. Please enter your California State Bar number (if applicable)

15. Membership Registration Status* (required)

Registrant 16

16. Name* (required)

First Last

16. Optional: Preferred First and Last Name for Conference Badge

16. Professional Title* (required)

16. Email* (required)

16. Primary Phone* (required)

16. Please enter your P.O.S.T number (if applicable)

16. Please enter your California State Bar number (if applicable)

16. Membership Registration Status* (required)

Registrant 17

17. Name* (required)

First Last

17. Optional: Preferred First and Last Name for Conference Badge

17. Professional Title* (required)

17. Email* (required)

17. Primary Phone* (required)

17. Please enter your P.O.S.T number (if applicable)

17. Please enter your California State Bar number (if applicable)

17. Membership Registration Status* (required)

Registrant 18

18. Name* (required)

First Last

18. Optional: Preferred First and Last Name for Conference Badge

18. Professional Title* (required)

18. Email* (required)

18. Primary Phone* (required)

18. Please enter your P.O.S.T number (if applicable)

18. Please enter your California State Bar number (if applicable)

18. Membership Registration Status* (required)

Payment Details

This field is hidden when viewing the form

Discount Code

Total

Payment Type* (required)

Credit Card

Check

Purchase Order

An Invoice / Purchase Order will be sent to the Registration Coordinator email entered on the first page of this registration request.

Pay by Check Acknowledgement* (required)

I acknowledge that registration will be paid in full within 5 business days after this registration submission date.

Remittance address will be provided in confirmation email.

Purchase Order Acknowledgement* (required)

I acknowledge that this registration will be paid in full within 30 business days after this registration submission date.

Remittance address will be provided in confirmation email.

Please Note:
If your total is $0.00, there is no need to enter your credit card or billing address information. You need only to click the registration button below the payment fields to register.

You can shop at annualantifraudconference.com with confidence. We have partnered with Authorize.Net, a leading payment gateway since 1996, to accept credit cards and electronic check payments safely and securely for our customers.
The Authorize.Net Payment Gateway manages the complex routing of sensitive customer information through the electronic check and credit card processing networks. See an online payments diagram to see how it works.

The company adheres to strict industry standards for payment processing, including:

128-bit Secure Sockets Layer (SSL) technology for secure Internet Protocol (IP) transactions.
Industry leading encryption hardware and software methods and security protocols to protect customer information.
Compliance with the Payment Card Industry Data Security Standard (PCI DSS).
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Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Billing Address

Same as Organization Address (from page 1)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

CAPTCHA

Please click the Register Button only once to avoid submitting the form multiple times.

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