Executive Assembly Meeting Registration Form

NYSCOPBA

Executive Assembly Meeting Registration Form

Holiday Inn - Albany, NY - February 11 & 12, 2009

Please complete this form no later than JANUARY 23, 2009 in order for proper arrangements to be made.

NOTE This form is to be completed by the CSS or his/her designee ONLY!!!

Address: *

Phone Number: *

Email:

Sector:

How Many Attending:

How many will be attending from this sector? (exclude yourself)

Date of Arrival:

Date of Departure:

Smoking Preference:

Smoker

Non-Smoker

EOL Time:

If you are requesting the additional 4 hours of EOL time, please include your work shift, hours and date(s) needed in this field. You MUST work an afternoon or evening shift and be at least 200 miles from the meeting location to be granted the additional travel time.

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New York State Correctional Officers & Police Benevolent Association, Inc.

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contact

NYSCOPBA

Executive Assembly Meeting Registration Form

Holiday Inn - Albany, NY - February 11 & 12, 2009

Please complete this form no later than JANUARY 23, 2009 in order for proper arrangements to be made.

NOTE This form is to be completed by the CSS or his/her designee ONLY!!!

New York State Correctional Officers & Police Benevolent Association, Inc.

Primary links

mainMenu

menu3

contact

NYSCOPBA

Executive Assembly Meeting Registration Form

Holiday Inn - Albany, NY - February 11 & 12, 2009

Please complete this form no later than JANUARY 23, 2009 in order for proper arrangements to be made.

** NOTE ** This form is to be completed by the CSS or his/her designee ONLY!!!

NOTE This form is to be completed by the CSS or his/her designee ONLY!!!