Registration Form - 2014 National Electrical Code Changes printable pdf download

Registration Form - 2014 National Electrical Code Changes

Please make copies of this

East End Inspection Agency

form for each attendee

E.E.I.

PO Box 35

East Quogue, New York 11942

631 594-2272 Fax 631 594-2598

Registration form – 2014 National Electrical Code Changes

March 5, 2016 8am – 4pm

Neighborhood House 92 Three Mile Harbor Rd East Hampton, New York

Name:_________________________________________________________________________

Employer:______________________________________________________________________

Phone Number:____________________________Cell:__________________________________

Email:__________________________________________________________________________

Mailing Address;__________________________________________________________________

Advanced Registration Fee

Walk-in Registration Fee

Space is limited. Seating is not guaranteed

If received by 2/27/16

$175.00

$200.00

Payment options:

--Send Check Payable to East End Inspection Agency to PO Box 35 East Quogue, NY 11942.

--Fax back the registration form with credit card information to 631 594-2598.

Applicant will not be registered until payment is received

Credit Card: ___ Master Card/Visa

Name______________________________________

FOUR WAYS TO REGISTER

Card Number:________________________________

1.-Mail Form to:

Expiration Date:_______________________________

PO Box 35

Billing Zip Code:_______________________________

East Quogue, NY 11942

Security Code:________________

2.-Phone: For further information,

please call Jenn at 631 594-2272

Fee Includes the course book – 2014 NEC Analysis of Changes

3.-Fax Form to: 631 594-2598

- NEC 2014 Code Books will be available for purchase on a first come

4.-At the door (walk-ins) will be able

to attend if space is available.

first serve basis.

Registration Form - 2014 National Electrical Code Changes