Joint Conference Registration Form

Personal Information

First name:
Last name:
(if applicable)
(e.g. RP or CRP)
Local Association:
(if applicable)

     (no abbreviations, please...for instance, we have 5 MPA's!)
Daytime phone number:
Company name:
(if mailing address is not residential)
Mailing street address, line 1:
Mailing street address, line 2:
(if needed)
Postal code:

Conference Registration

Regulation Conference
Certification Conference    (must be a NFPA member to attend)
Leadership Conference    (must be a NFPA member to attend)
Dietary Restrictions
What do the caterers need to be aware of? e.g. “no peanuts; diabetic

Note: It is recommended that persons with severe food allergies or intolerances provide their own meals.

Social Events

The social events are at attendees' expense; the questions here are so we can provide an approximate head count to the venues.

Substitutions, Cancellations & Refunds

If you cannot attend you may send a substitute. Requests for substitution must be submitted in writing by e-mail, fax or regular mail. If you must cancel, requests must be made in writing by e-mail, fax or regular mail. Cancellation fee of $25 if cancelled by March 14. No refunds for cancellations after that date.

NFPA reserves the right to photograph and/or videotape the proceedings at the Joint Conference and to use the images for educational and promotional activities without compensation.


modified 1/28/2014

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