WVEA Professional Issues Conference

Registration Form


October 15-16, 2010

Marriott Hotel

Charleston, West Virginia

 

Click on the printer icon on the left sidebar, print and mail to WVEA.

 

Name ________________________________________________________

 

Address  _____________________________________________________

 

County _______________________________________________________

 

City  _________________________________________________________

 

State ____________________________________

 

Zip ______________________________________

 

Phone (H) ________________________________

 

Phone (W) ________________________________

 

E-mail ____________________________________

 

Registration Category:

 

Member/per person rates

 

_____$50 double           _____$80 single          _____$30 commuter

 

Non-member rate/per person rates

 

_____ $100 double        _____ $150 single       _____ $60 commuter

 

Roommate’s Name:  (if applicable)  ____________________________________

 

 

Make checks payable to WVEA PIC Conference and mail to:

WVEA/PIC, 1558 Quarrier Street, Charleston, WV 25311

 

For further information contact Kym Randolph at 1.800.642.8261 extension 211 or Anita Maxwell at 1.800.642.8261 extension 116.

 

REGISTRATION DEADLINE: October 1, 2009