Registration Form

Posted bynena-9-1-1

Registration Form

WI-NENA 2001 Fall Conference

Use this form to register for the conference:

Submit on-line by completing the form andclicking the “Submit” button at the bottom of the page.

or, Complete the form, print it out and mail itto:

WI-NENA c/o Ameritech 9-1-1 Public Safety, LowerLevel, 2140 Davidson Rd. Waukesha, WI 53186

with a check payable to WI-NENA or provide yourMaster Card or VISA information.

Applications submitted without check or creditcard information will be billed.

**Please note we donot currently provide for secure transactions on this site.**

Conference questions should be directed to MaryOrlowski, (414) 678-5840 or email: [email protected]

Attendee Information: (Please register only one attendee and guest per form)

(As you would like it to appear on your name badge)

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(As you would it to appear on your name badge)

Registration Fees:

Registration fees include:

     All education sessions, admittance to the exhibit area, registration materials, Welcome Reception, refreshments, Monday Lunch and Vendor Reception and Tuesday night party and dinner.

Spouse or Guest Registration:

   Tuesday night party and dinner only.

 Vendor Only passes:

     Includes Monday Lunch and Vendor Reception.

Pre-Conference Course:

     Includes lunch and handouts.

                                                                                                  Early Registration                  Regular Registration

                                                                              postmarked: (by Aug. 15, 2001)                        (after Aug 15, 2001)

NENA Member                                                                                $80                                                $90

Non-Member                                                                                    $90                                                $100

Vendor Only/One Day Only Pass                                                       $35                                                $35

800 Mhz Panel Discussion Only (Wed, Oct 3, 9-12am)                      $25                                                $25                      

Yes! I plan to attend the Tuesday night Reception and Dinner.

Yes! I will be accompanied by a Spouse/Guest.  ($30)

Yes! I will attend the Pre-conference Course!  School and Workplace Violence($75)

If you would like to submit your credit card information, complete the fields below.

**Remember our site is not currently a secure site.**

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See you at the conference!