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, 48 S. Service Road, Suite 401, Melville, NY 11747.

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

Event Name:
Please Select One... LICA Fall Breakfast LICA Holiday Party

Company Information:

Company Name:


Membership Status:
Please Select A Status Elected/Appointed Officials (FREE) Invited Guest/VIP (FREE) LICA Member/Partner (FREE) Non-LICA Member ($50)

Contact Person:


Contact Phone:
() -

Contact E-mail Address:


Number Of Attendees: (Please list Attendee Names Below)

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Attendee Information:

Attendee #1:	Attendee #6:
Attendee #2:	Attendee #7:
Attendee #3:	Attendee #8:
Attendee #4:	Attendee #9:
Attendee #5:	Attendee #10:

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Deadline is 2 weeks prior to event!

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All sponsorships include:

• Table for Ten Attendees
• Event Signage & Recognition*

Bridge Sponsors receive prime seating and more prominent signage placement.

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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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