NJEPA 2020 Conference
This form is to determine your choice in options for the 2020 NJEPA Conference. NJEPA will use your information below for cancellation, carryover, reimbursement and refund when selected. Please allow 2-4 weeks for processing your selection.
What is your first and last name?
What is the name of your employer or business? If you are not affiliated with an organization please state "none"
When registering for the conference, what email did you submit for confirmation and updates?( If different then the email inputted above)
If you were part of a group registration, please add names of others in your group (if known)
Please provide a phone number in the event that we need to contact you
Your option regarding your 2020 NJEPA Registration
Please apply my 2020 registration and payment towards the 2021 Conference (you will receive a confirmation email)
Please cancel my registration and reimburse any payments
Donate my registration fee to NJEPA ( you will receive a thank you letter with donation amount and agency tax ID information)
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This form was created inside of New Jersey Emergency Preparedness Association.