Registration Form

Central Emergency Services
2008 Pride & Ownership Conference

 Registration Fee $230.00
Group Discount $100.00 / each
 
Total: 
  Name:
  Organization:
  Address:
   
  Phone:
  Email:
     
  Payment:  
Check  
P.O. #:
     
  Signature: _______________________________________

Please complete this online form and print. Return signed & completed form and payment information to:

Training & Safety Officer
c/o Central Emergency Services
231 S. Binkley Street
Soldotna, AK 99669
 
(907) 262-4792 Main Office
(907) 262-5770 Fax