Welcome to LICA’s online event registration page. Please use this form to register attendance and/or to take a sponsorship for upcoming LICA events. Credit card payment for sponsorship or non-member registration fees (if applicable) can be made online after you submit this form. If you prefer to pay by check instead, please state that in the Notes field at the end of the form, then make your check payable to LICA and mail to: LICA, 150 Motor Pkwy, Suite 307, Hauppauge, NY 11788.

For more information about each event, please click here. We look forward to seeing you soon.

Event Name:
Please Select One... LICA 2019 Safety Seminar & Training

Company Information:

Company Name:


Membership Status:
Please Select A Status LICA Member (free of charge) Non-Member ($25)

Contact Person:


Contact Phone:
() -

Contact E-mail Address:


Number Of Attendees: (List Names & Choose Sessions Below)

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Attendee Information:

Attendee #1: All 3 Sessions Individual Sessions Session 1: New York 811 Session 2: ARTBA Training - PDH Credits Session 3: OSHA Illness & Injury Reporting

Attendee #2: All 3 Sessions Individual Sessions Session 1: New York 811 Session 2: ARTBA Training - PDH Credits Session 3: OSHA Illness & Injury Reporting

Attendee #3: All 3 Sessions Individual Sessions Session 1: New York 811 Session 2: ARTBA Training - PDH Credits Session 3: OSHA Illness & Injury Reporting

Attendee #4: All 3 Sessions Individual Sessions Session 1: New York 811 Session 2: ARTBA Training - PDH Credits Session 3: OSHA Illness & Injury Reporting

Attendee #5: All 3 Sessions Individual Sessions Session 1: New York 811 Session 2: ARTBA Training - PDH Credits Session 3: OSHA Illness & Injury Reporting

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All sponsorships include:

• Up to Ten Attendees for Safety Seminar
• Event Signage & Recognition*

BE A LICA EVENT SPONSOR (Optional)

--Choose an Option-- Bridge Sponsor ($1,000) Highway Sponsor ($500)

Contact Lynn Barker at: to provide ad or logo artwork.

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Notes / Special Requests

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By clicking the "Continue Registration" button below, your registration information will be sent to LICA. Please review all information above before you continue.

Please check the “I’m not a robot” box below to submit this form