NTCTELA Membership and Conference Registration - 2019
Filling out this form will generate a pdf invoice that will be automatically sent the the email address you provide. Please allow up to 24 hours for the pdf to be generated. If you do not receive the invoice, please check your spam folder. Your registration will not be considered complete until you mail the pdf invoice and your $95 payment. No payments will be collected at the door, and all unpaid registrations will be canceled on June 1, 2019.
Hurst Conference Center
Friday, June 7, 2019
7:45-3:30
includes lunch
First Name *
Your answer
Last Name *
Your answer
District/Organization *
Your answer
Primary Email Address *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Personal Phone (Area Code Only) *
Your answer
Personal Phone Number (do not include area code here) *
Your answer
District Contact Name for Accounts Payable *
Your answer
District Contact Person for Accounts Payable Email *
Your answer
Level *
Required
Role - Check all that apply *
Required
Optional Secondary Email Address
Your answer
Which speaker are you most interested in hearing? *
Which speaker ranks second in your level of interest? *
Which speaker ranks third in your level of interest? *
Which speaker ranks fourth in your level of interest? *
Dietary Constraints - We are only able to offer a vegetarian and non-vegetarian options. If you have other restrictions, please select none, and plan on bringing your lunch that day. *
Required
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