2012 Conference Registration Form

The rates for this conference are $205 for Members and $235 for non-Members. To be eligible for the member rate, your dues AND registration must be paid by September 1st.

In addition RIPPA members enjoy a discounted subsidized rate of $102.50 for members and $117.50 for non-Members.

Full-time Students receive a discounted rate of $120 with proper school identification and may attend the entire conference.

A One-Day only rate is also available at $120 per day ~ please be sure to indicate which day you plan to attend (Monday or Tuesday)

To submit your form online, simply fill out the information below and click submit and you will be taken to a confirmation page. Pay online by using PayPal.

First Name:*
Last Name:*
Title:
Organization:*
Street Address:*
Address (cont):
City:*
State/Province:*
Zip/Postal Code:*
Country:
Work Phone:*
Fax:
Email:*
Registration Option:*
Choose one of the following options:
Check MAIL to: NECCD PO Box 14098 East Providence RI 02914
PayPal (Once you submit the form a link will become available for you to pay using PayPal)
Agency/Department Check **
Security Code:

* Required Fields

Conference Information

2012 Conference Registration Form