Registration Form

NENA Annual Conference June 21 – 25, 1998
Registration Form
Please download this form and print or type your information. Pleaseregister just one attendee and guest per form.

Attendee Information
Name	Last _____________________________________________	First __________________________________
		(as it should appear on your name badge)
NENA Membership Number	____________
First Time Annual Conference Attendee	_____ Yes
Title	_________________________________________________
Agency/Company	_________________________________________________
Address	_________________________________________________
City, State/Province, Zip Code	_________________________________________________
phone (work)	Phone ___________________________________	Fax _______________________________
Spouse/Guest	Name ____________________________________________
	(As it should appear on his/her name badge)

Attendee Information – Please circle just ONEin each section

Employer Category
01 9-1-1 Board	05 Consultant Services	09 Fire Department
02 Government Board	06 Equipment Vendor/Distributor	10 EMS
03 Telephone Company	07 Equip. Manufacturer/Developer	11 Other ______________
04 Independent System Provider	08 Police Department

Job Classification
01Director, Agency Head, Supervisor	06 Education & Training	11 Other ______________
02 Marketing/Sales	07 Emerg. Responder, Service Provider	12 9-1-1 Product Mgr.
03 Project Engineer/Systems Designer	08 Dispatcher/Call Taker/Radio Opera.	13 County Elected Official
04 DB Mgr./DB Developer/Addressing	09 Equip. Installation/System Install.
05 Data Base/Clerical	10 9-1-1 Coordinator

Registration Fees

Registration fees for NENA Members and Non-members include: alleducational sessions, admittance to exhibit area, registration materials, WelcomeReception, refreshments & Wednesday night party & dinner. Non-members also receivea one year membership in the association ($60). Spouse or Guest Registration includesregistration materials, Welcome Reception, and Wednesday night party & dinner.
Tuesday Only Day Pass registration includes: Tuesday educational sessions, admittance toexhibit area on Tuesday, and limited registration maters. Non-member Day Pass Registrationalso includes a 1-year NENA members – a $60 value!

Attendee Category		Early Registration		(postmarked		Regular Registration		(postmarked
NENA Member		_____ $325		by 5/15/98)		_____ $355		after 5/15/98)
Non-Member		_____ $385				_____ $415

Referred by NENA member: ___________________________________________

Spouse/Guest

_____ $125

_____ $125

NOTE: This category limited to guest or spouse notemployed or working in the 9-1-1 industry

Tuesday Only Day Pass

_____ $65 non-members

_____ $20 members

_____ $75 non-members

_____$25 members

Pre-Conference Courses – Sunday, June 21, 1998

The 9-1-1 Puzzle

_____ $195

_____ $195

E9-1-1 Data Base

_____ $195

_____ $195

Managing the 9-1-1 Center

_____ $195

_____ $195

Optional Tours:

Cincinnati Reds Baseball		Monday, June 22		I would like _____ tickets at $14 each = ___________
Cincinnati Highlight Cruise		Sunday, June 21		I would like _____ tickets at $57 each = ___________
United States Air Force Museum		Tuesday, June 23		I would like _____ tickets at $25 each = ___________

Payment Information

______	Check Enclosed, Payable to NENA (US Funds)
	47849 Papermill Rd; Coshocton, OH 43812-9724

______

VISA

______

MasterCard

______

American Express

Fax Completed Registration Form to (740) 622-2090

Credit Card Number	__________________________________	Expiration Date	________
Signature	__________________________________

Total your costs here:

Attendee Registration	__________
Spouse/Guest Registration	__________
Tuesday Only Day Pass	__________
Course Fee Total	__________
Tour Ticket Total	__________
TOTAL ENCLOSED	__________

WE ARE UNABLE TO ACCEPT PHONE REGISTRATIONS. CANCELLATIONS RECEIVEDBEFORE MAY 15, 1998 WILL BE CHARGED A $50 FEE.
NO REFUNDS CAN BE GIVEN AFTER THIS DATE.

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