Name_________________________________ DATE____________________
Organization____________________________
Address (Home Organization )
Street_________________________________________________________________
City / State / Zip_________________________
Phone _____________________________
Fax _______________________________
E-Mail______________________________
ACA Number for Member Discount__________
SSN_______________
Special
Needs__________________________________________________________________
_______________________________________________________________________
Attending Full Workshop & Registering before 2/15/02
_____Member (s)@ $110.00 = $__________
_____Non-Member (s)@ $155.00 = $________
Full Workshop & Registering after 2/15/02
_____Member (s)@ $120.00 = $__________
_____Non-Member (s)@ $165.00 = $________
Single Day _____3/22 _____3/23
_____Member (s)
before 2/15/02@ $ 65.00 = $__________
_____Member (s)
After 2/15/02 @ $ 75.00 = $__________
_____Non-Member (s)
Before 2/15/02 @ $110.00 = $__________
_____Non-Member (s)
after 2/15/02 @ $ 120.00 = $__________
TOTAL Investment $__________
All NECA members can earn discounted for FREE registration for the full NECA Annual Workshop. A member who submits a registration form with another person who is not a current member NECA member will receive a 50% discount from their own registration fee. If two such new registrations are submitted, the NECA member will be allowed to register FREE. For purposes of this program, 'non-member' may include a former member of NECA.
Please send your registration with payment in advance to:
Bill Fenson
The Skills Emporium, LLC
www.HR-Guides.com
68 Chenango Street
Binghamton, NY 13901-2902
Voice: 607/ 722-1514
NECA President
www.employmentcounseling.org