Annual Conference Registration

 

Member's First Name: Middle I:

 

Member's Last Name:

 

Fire Department:

 

Mailing Address:

 

City: State: Zip:

 

Partner's Name:

 

Phone Number: Email Address:

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Pre-registration fee (due before July 1st)  $150.00

 

Late registration fee (due after July 1st)  $200.00

 

Training $64.00

 

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**Note** One banquet ticket and one lunch ticket are included in your registration fee.  Daily registration is available at the conference for $80.00 per day. Meals are not included with daily registration. Check if needed:   I will need extra banquet ticket(s) @ $45.00 each. I will need extra lunch ticket(s) @ $21.00 each.                 Total Amount For All Selected Items: $