Registering for Chiefs' In-Service and Annual Conference:
Name:*
Agency:*
Address:
District Number
E-mail:*
Phone Number:
Are you a PELC Graduate?
Are you a CLEE Graduate?
Is this your first conference?
REGISTRATION (includes meals, lodging & breaks). Please select your preference(s):
$200 - Guest/Spouse Attending (includes same room lodging & meals):
If Guest/Spouse is attending please note name below:
Membership Dues for October 1, 2017 thru September 30, 2018. IF APPLICABLE, please select one option:
Do you plan to stay overnight at the hotel? (room reservations are made by OACP)
Would you like to receive a hard copy of the conference handouts on-site?
Dietary Needs?
Comments: