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Nebraska Cooperative Extension Association
November 29 & 30, 2017
Younes Conference Center, Kearney NE
Questions Regarding Registration or Due? Contact: Jessica G. Jones (402-335-3669 or
jjones12@unl.edu
)
* Indicates required question
2017 Conference Registration & 2018 Section Dues
First Name
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Your answer
Last Name
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Your answer
Email
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Your answer
Address
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Your answer
Town
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Your answer
Zip Code
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Your answer
Phone Number
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Your answer
District
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Campus
Metro
Northeast
Panhandle
Southeast
West Central
Are you joining NCEA for the first time in 2018?
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Yes
No
2018 NCEA Membership Dues (check all that apply)
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NCEA Dues (Mandatory) = $15
4-H Section Dues = $90
Ag Section Dues = $85
ANREP Section Dues = $60
FCS Section Dues = $120
NACDEP Section Dues (includes state dues) = $95
NACDEP Section Dues (state only) = $20
Specialist Section Dues = $10
Epsilon Sigma Phi (ESP) Renewal = $55
Eplison Sigma Phi (ESP) New Member = $60
Epsilon Sigma Phi Lifetime - Retirement = $200
Required
Do you plan on attending the 2017 NCEA conference?
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Yes
No
Are you purchasing conference meals for the 2017 NCEA Conference?
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Yes, meals (includes: Wednesday dinner, Thursday lunch & breaks) = $50
No
Do you have any dietary restrictions?
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None
Vegetarian
Vegan
Kosher
Gluten-free
Other:
I understand I will need to go to the payment site or mail a check to finalize my registration and dues?
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Yes
How will you pay your dues?
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Payment site using credit card (note: you will be assessed a processing fee)
Mail in check made payable to NCEA, to: NCEA, c/o Jessica Jones, PO Box 779, Tecumseh NE 68450
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