2019 Public Works
Training School
Hotel Ithaca
October 21-23
Attendee Registration
First Name
*
Last Name
*
Title
*
Municipality/Organization
*
(Choose One)
City of
Village of
Organization
Address
*
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
AA
AE
AP
Email
*
Phone Number
*
First Time Attendee at Public Works School
*
(Choose One)
Yes
No
Changed name or municipality in the past year?
(Choose One)
Yes
No
Guest/Spouse Full Name
Dietary Needs
Registration Rates
Registration Options
*
Full Program Rates
One Day Program Rates
Full Day Program Rates
*
First-Time Attendee City/Village (Municipality) ($175.00)
Member City/Village (Municipality) ($310.00)
Non-Member (Municipality) ($510.00)
NYCOM Network (Gold/Silver/Bronze) ($420.00)
Other Company/Organization ($560.00)
Meal Options
Choose One
*
Do not need to purchase meals (Staying at host hotel)
Need to purchase meals (Commuting or other accommodations)
Not participating in meal functions
Monday
Breakfast ($20.00)
Lunch ($25.00)
Dinner ($40.00)
Tuesday
Breakfast ($20.00)
Lunch ($25.00)
Wednesday
Breakfast ($20.00)
Total
$310.00
Payment Options
Public Works School Payment
*
(Choose One)
Voucher
Check
Credit Card
Save Registrant
Event Registration Software by RegFox
