Regional Registration Form

Regional Con­fer­ence

April 17/24, 2015

Reg­is­tra­tion

 

To reg­is­ter, please print and return this reg­is­tra­tion form with pay­ment to your appro­pri­ate region rep­re­sen­ta­tive by April 3, 2015.

 

East­ern Regional Con­fer­ence                       Cen­tral Regional Con­fer­ence                       West­ern Regional Conference

April 24, 2015                                     April 17, 2015                                     April 17, 2015

Chair: Dana Sauls                              Chair:              Tammy White                                    Chairs:  Joanne Matz

Beau­fort Com­mu­nity Col­lege             Forsyth Tech Com­mu­nity Col­lege                   JamiMcSwain

Build­ing 1 Room 6                              All­man 347                                          Gas­ton  College

5337 US Hwy 264E                              2100 Silas Creek Pkwy                                    201 High­way 321 South

Wash­ing­ton, NC                                  Winston-Salem NC 27103                   Dal­las, NC 29037

(252) 940‑6391                                   (336) 757‑3213                                   (704) 922‑6200

 

Name:  __________________________________________________________

Insti­tu­tion: _______________________________________________________

Address: _________________________________________________________

City: _____________________________   State: _______   Zip: ____________

Phone: ____________________  Email: ________________________________

Con­fer­ence fee: $15 for members/ $20 for non-members

 

NCADE Mem­ber?  o Yes   o No                             Amount Enclosed: _______

 

Main Area of Interest:

 

  • o DMA (MAT)     o DRE (RED/ENG)        o Admin­is­tra­tion (both areas)

 

 

  • o I would like to request a veg­e­tar­ian meal

 

Other dietary restric­tions: ___________________________________________

 

 

If you need addi­tional infor­ma­tion, you may go to www.ncade.net, con­tact your regional rep­re­sen­ta­tive listed above or Wes Anthony at anthonyw@clevelandcc.edu