TDC Conference March 1 – 4, 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 | ____________ | |
| 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) |
Registration Fees
Registration Categories:
A or B: All educational sessions, registrationmaterials, Welcome Reception, and refreshment breaks.
C: One-year NENA membership ($75), alleducational sessions, registration materials, Welcome Reception,and refreshment breaks.
D: Welcome Reception.
Additional Fees: “E9-1-1 Data Base”includes 8-hour course, course materials, lunch and refreshmentbreaks. “Managing the 9-1-1 Center” includes 6-hourcourse, course materials, lunch and refreshment breaks.
| Registration Category | Regular Registration* | (postmarked | ||||
| A NENA Member | _____ $420 | after 2/11/98) | ||||
| B Non-Member | _____ $420 | |||||
| C New NENA Member | _____ $495 | |||||
| D Spouse/Guest | _____ $30 |
*On-site registrations will be charged anadditional fee of $30.
Referred by NENA member:___________________________________________
Pre-Conference Seminars – Sunday, March4, 1998
| E9-1-1 Data Base | _____ $195 | _____ $195 | ||||||||||||
| Managing the 9-1-1 Center | _____ $195 | _____ $195 |
* on-site registrations will be charged anadditional fee of $30
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 | __________________________________ |
Track Selection
To help us in determining room size, pleaseindicate ONE track in which you will most likely participate.
| _____ | Network | _____ | Data | _____ | ALEC/PS | _____ | PSAP/CPE |
Total your costs here:
| Attendee Registration | __________ |
| Spouse/Guest Registration | __________ |
| Course Fee Total | __________ |
| TOTAL ENCLOSED | __________ |
No refunds can be given after February11, 1998