Company Information

Supervisor Information

Enter registrant info (up to five names)

Registrant 1:

Registrant 2: (leave blank if no attendee)

Registrant 3: (leave blank if no attendee)

Registrant 4: (leave blank if no attendee)

Registrant 5: (leave blank if no attendee)

Cancellation Policy and Payment Agreement:

To submit this registration, please check the box below to confirm that you agree to the “per person” cost of the selected program and acknowledge that if the program is cancelled NEPPA will credit any payment made, either in full or pro-rated, depending on the program.

Cancellations are accepted until two weeks prior to the start of the program.  Substitutions may be made at any time (prior to the start of the program).

NEPPA takes photographs during its meetings and events for use in association advertising, newsletter and other promotional materials, whether in print, electronic or other media, including the NEPPA website. By participating in this event, you authorize NEPPA the right to use my name and photograph for such purposes.