Registration Form

NENA Annual Conference June 21 -25, 1998
Registration Form
Please download this form and print or typeyour information. Please register just one attendee and guest perform.

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 – Pleasecircle just ONE in 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 andNon-members include: all educational sessions, admittance toexhibit area, registration materials, Welcome Reception,refreshments & Wednesday night party & dinner.Non-members also receive a one year membership in the association($60). Spouse or Guest Registration includes registrationmaterials, Welcome Reception, and Wednesday night party &dinner.
Tuesday Only Day Pass registration includes: Tuesday educationalsessions, admittance to exhibit area on Tuesday, and limitedregistration maters. Non-member Day Pass Registration alsoincludes 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, June21, 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 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 RECEIVED BEFORE MAY 15, 1998 WILLBE CHARGED A $50 FEE.
NO REFUNDS CAN BE GIVEN AFTER THIS DATE.