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2010 PACIFIC NORTHWEST FIRE INVESTIGATION

CONFERENCE REGISTRATION

Mail or fax this form ~

Print Name: ___________________________________________________________

Mailing Address:

_______________________________________________________

Send To: Pacific NW Fire Investigation Conference 13375 Central Valley Rd. Poulsbo WA 98370-7040 Fax To: 360-447-3590 ATN: Registration

______________________________________________________

City

State

Zip

Organization:

______________________________________________________________________________

Position: __________________________________________________________________________________

Work Email Address:

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Telephone Number: (

) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

  • Check Enclosed

  • Bill My Agency- PO # Required

_____________________________

City

State

Track: (Circle One)

Basic

Intermediate1

Send Bill To:

_______________________________________________________________________________ Name _____________________________________________________________________________ Address ____________________________________________________________________________

Zip

Intermediate 2

Advanced

(Check box) if you intend to take the IFSAC or IAAI Written Examination for CFI

  • Check this box for Washington State IAAI members & if you plan to attend Monday s sponsored IAAI

Luncheon for members

  • Check this box for Northwest Fire Investigators Association members & if you plan to attend Tuesday s

sponsored NWFI Luncheon for members

Conference Registration Fee $375 Early Registration (Before April 1, 2010) Includes free conference shirt! $425 Late Registration- (After April 1, 2010), Does NOT include conference shirt

Includes: Lectures, handout materials, training certificate, and BBQ Dinner.

T-Shirt Size: (Circle) Free T-shirt prior to April 1st

XXL only

XL

L

M

S

Cancellation Policy- All cancellations made prior to April 1st may be refunded in full if books and other class handouts have not been ordered. Cancellations requested after April 1st will be charged the full conference rate. (Northwest Fire Investigators Association reserve the right to alter course content and instructors based on terms, availability, and confirmation).

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