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REGISTRATION FORM

REGISTRATION DEADLINE IS FRIDAY, SEPTEMBER 22

 

OCTOBER 11-13, 2023

RADISSON HOTEL & CONFERENCE CENTER

GREEN BAY, WI

Please fill out the form below to register you (and your guests) for the ASCEND Conference. You do not need to submit the form if you are not attending the ASCEND Conference. Once you submit the form, you will be directed to a page with online payment options. The conference fee is $100 per Representative registration, $25 per additional guest, per day, and an additional $25 per guest for the dinner and awards ceremony. Registration closes September 22nd.

If paying by check, please send to:


Packerland Brokerage Services

ATTN: Mara Maidi

432 Security Blvd.

Green Bay, WI 54313

PLEASE FILL OUT THE FORM BELOW. THE FORM MAY TAKE A SECOND TO LOAD.

PLEASE ONLY FILL OUT THIS FORM IF YOU ARE ATTENDING THE ASCEND CONFERENCE IN GREEN BAY, WI.

If you are not attending the 2023 ASCEND Conference, you do not need to RSVP in any way.

REPRESENTATIVE REGISTRATION

REPRESENTATIVE INFORMATION

Representative Name*

Will you be bringing a guest and/or assistant to any part of the ASCEND Conference (e.g. the Awards Dinner or any sessions)

If you answered "yes", you will be asked additional questions further down this registration form.

ANNUAL REQUIREMENTS FOR ALL REGISTERED REPRESENTATIVES

All Representatives must complete four different annual requirements by the end of each calendar year. If attending the ASCEND Conference, Representatives may complete two of their four annual requirements in-person at the ASCEND Conference. The remaining two annual requirements must be completed online through our vendor Quest CE. Alternatively, Representatives attending the ASCEND Conference may choose to complete all four of their annual requirements online through our vendor, Quest CE. Any Representative NOT attending the ASCEND Conference must complete all four annual requirements online.

 

The deadline for all Reps to complete all requirements is 12/31/2023. Access to online requirements doesn't open until 10/13/23.

 

You do not need to fill out this form if you are not attending the conference. You can fulfil your requirements online through Quest CE without submitting this form. This only applies to conference registration. 

Annual Requirements for All Representatives:

  • Compliance Meeting: offered both online and in-person at the ASCEND Conference

  • Firm Element Part I/Anti-Money Laundering: offered both online and in-person at the ASCEND Conference

  • Firm Element Part II: offered online only

  • Compliance Questionnaire: offered online only

Conference Requirements Schedule and Sign-Up:

The Compliance and the Firm Element Part 1/Anti-Money Laundering courses will be presented twice during the ASCEND Conference. On Wednesday, October 11, both courses will be presented at 8:00 AM. You can choose which, if any, to attend. On Thursday, October 12, both courses will be presented again at 3:50 PM. You can choose which, if any, to attend. 

You must sign-up for these courses in advance! At the conference, we will remind you of which courses you registered for.

Annual Requirement Course Sign-Up

If you selected an "ONLY" option, please note that you must take the remaining course (Firm Element Part I/AML or Compliance) online in addition to the other two required online courses (Firm Element Part II and Compliance Questionnaire).

Total Fees for ALL Requirements:

  • Representatives who do not attend the 2023 ASCEND Conference will pay the normal fee of $250 (this covers all four requirements).

  • Representatives who attend the 2023 ASCEND Conference will pay a discounted fee of $125. Even if you attend the conference, but choose not to complete any of the requirements in-person, you still qualify for the discount. (The $125 requirement fee is in addition to the cost of attending conference. You will be invoiced $125 for the courses after the conference).

  • Since Packerland has prepaid all fees to Quest CE (online course vendor), you do not need to pay prior to taking the courses online. Just sign-in and complete. You will receive an invoice for your courses after conference. You will receive more instructions about annual requirements from the Compliance department in the fall of 2023. 

Requirement Questions? Contact:

Chad Rohm, Compliance Officer, at chadr@pbshq.com (920-662-9500) or Victor Kuehl, Compliance Specialist, at victork@pbshq.com (920-662-9500).

SPECIFIC ADDITIONAL CONFERENCE INFORMATION

Check all additional activities you will be attending

Awards Dinner Entree Choice (Descriptions Below)

Entree

Mediterranean Chicken Picatta - Pan seared chicken breast served over linguine with garlic sun-dried tomatoes, mushrooms, artichoke hearts, and spinach. Topped with lemon-caper sauce.

Slow Roasted Cod - Fine Herb slow roasted cod. Served with baby red potatoes, basil pesto.

Boneless Pork Loin - Boneless pork loin with red wine cranberry glaze. Served with wild rice blend.

Vegetable Alfredo - Vegetarian and Gluten-Free. Fettuccine, spinach, zucchini, asparagus tossed with an alfredo sauce, topped with mozzarella and parmesan.

GUEST OR ASSISTANT INFORMATION

If you answered "yes" to having a guest or assistant joining you, please fill out the information below for them. If you answered "no", no questions will appear in this section and you can skip to the next section.

 

Guest/Assistant Fees: ($25 fee per person / per day)

Each additional person you bring is $25 per day. The Awards Dinner is also an additional $25 per each guest/assistant, even if they are attending sessions on Thursday. 

For example, if you are bringing two assistants, and both assistants are attending Wednesday, Thursday, and the Awards Dinner, it will be an additional $150 added on to your regular conference fee of $100, making your total $250. 

How many different guest(s)/assistant(s) are you bringing?
Is #1 a guest or an assistant?
Is #2 a guest or an assistant?
When is #1 Attending? (Check All)
Is #1 attending either annual requirement course?
#1's Annual Requirement Course Sign-Up
Check all Wednesday additional activities #1 will be attending
When is #2 Attending? (Check All)
Is #2 attending either annual requirement course?
#2's Annual Requirement Course Sign-Up
Check all Wednesday additional activities #2 will be attending
Check all Thursday additional activities #1 will be attending
#1's Awards Dinner Entree Choice:
Check all Thursday additional activities #2 will be attending
#2's Awards Dinner Entree Choice:
Is #3 a guest or an assistant?
Is #4 a guest or an assistant?
When is #3 Attending? (Check All)
Is #3 attending either annual requirement course?
#3's Annual Requirement Course Sign-Up
Check all Wednesday additional activities #3 will be attending
Check all Thursday additional activities #3 will be attending
#3's Awards Dinner Entree Choice:
When is #4 Attending? (Check All)
Is #4 attending either annual requirement course?
#4's Annual Requirement Course Sign-Up
Check all Wednesday additional activities #4 will be attending
Check all Thursday additional activities #4 will be attending
#4's Awards Dinner Entree Choice:
Is #5 a guest or an assistant?
Is #6 a guest or an assistant?
When is #5 Attending? (Check All)
Is #5 attending either annual requirement course?
#5's Annual Requirement Course Sign-Up
Check all Wednesday additional activities #5 will be attending
Check all Thursday additional activities #5 will be attending
#5's Awards Dinner Entree Choice:
When is #6 Attending? (Check All)
Is #6 attending either annual requirement course?
#6's Annual Requirement Course Sign-Up
Check all Wednesday additional activities #6 will be attending
Check all Thursday additional activities #6 will be attending
#6's Awards Dinner Entree Choice:

CONFERENCE IMAGE RELEASE

Your registration and attendance at this event indicates your consent to be photographed and to the use of your image in marketing collateral and for other promotional/editorial activities of Packerland Brokerage Services - for future use in any and all media, now known or hereafter created. From time to time, Packerland Brokerage Services uses photographs of conference events in our marketing materials; by virtue of their attendance, all conference visitors agree to the use of their likeness in such materials. Packerland Brokerage Services also reserves the right to use such images taken at the conference with your photograph and/or likeness on our website, social media, and/or in future new media channels to promote the organization. If you do not agree to this, please note in the comments below.

QUESTIONS/COMMENTS

Please note: For any questions or comments, someone from Packerland's Home Office will contact you shortly, or you can contact Danielle DeJardin at danielled@pbshq.com (920-662-9500) or Mara Maidi at maram@pbshq.com (920-662-9500). 

PAYMENT OPTIONS

There are two convenient ways to pay for the 2023 ASCEND Conference: online via credit card (you will be taken to a new page), or by check (we will send you an invoice). 

Please select one option below.

Payment Choice

SUBMIT YOUR FORM ONCE COMPLETED BY CLICKING THE ORANGE "SUBMIT REGISTRATION FORM" BUTTON BELOW.

If you chose "CREDIT CARD" for your payment choice, you will be taken to a new page after submitting your registration form. Please remember the amount of guest(s) you're bringing and day(s) they're coming, as you will need to supply that information when adding to your cart to checkout. The checkout page will ask for your shipping address, but please note that nothing will be shipped to you. You do not need to bring any ticket or receipt to the conference.

 

If a thank you box does not pop up after submitting your form, please click here or copy and paste this URL into your browser to pay via credit card: https://www.packerlandascend.com/product-page/representative-registration

If you do not pay on that page, you will be invoiced instead.

CONTACT US

If you have any questions or comments, please contact Danielle DeJardin

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