NCNEOA 2012 SPRING IN-SERVICE TRAINING SEMINAR
PRE-REGISTRATION FORM

AFTER PRINTING FORM, PLEASE MAIL TO TIM McLAWHORN

Please mail by May 1st - afterwards bring to the conference

(see address below)

Please fill in all the requested information

First Name: M.I.: Last Name:

Mailing Address:

City: State: Zipcode:

County: D.O.B.: / /

Home Phone: ( ) - Work Phone: ( ) -
EXT.:

EMAIL: SSN: - -

AGENCY:

RANK: Number of Years in Narcotics:

Requested Training:

In-Service Seminar Registration Fee: $150   
Pre-Registration Ends May 1, 2012
(After this date you will have to pay $175 at the seminar)

Make checks payable to: NCNEOA

Please print this form and mail it with your registration fee to:

Tim McLawhorn
95 Edgewater Rd
Washington, NC 27889

Registration begins Sunday, May 20, 2012 at 3:00 pm
Training begins Monday, May 21 thru Thursday, May 24, 2012

Your Hotel Reservations are your responsibility:
Marriott Carolina Beach Courtyard
Phone: (910) 458-2030

NCNEOA is a non-profit organization Tax ID #56-1917180