30th Annual Conference Registration
Sharing for Success
Name:
(Type as it is to appear on badge)

Institution:Daytime Phone:

Mailing Address:

Registration (includes breaks and Meals)
Pre-Registration Full Conference by June 15	$50.00
Pre-Registration One Day by June 15	$25.00
On site registration Full Conference	$60.00
On site registration One Day	$30.00
NCCCLRA Membership Dues
Salary less than $15,000	$5.00
Salary more than $15,000	$10.00
Scholarship Donation (Tax Deductible)
Total Fees Enclosed	____________

Complete registration form by June 15. Mail check (payable to NCCCLRA) to:
Deborah Foster, Treasurer
Fayetteville Technical Community College
PO Box 35236
Fayetteville, NC 28303-0236
910-687-8257
fosterd@faytechcc.edu

Registration includes the following events. Please check if attending.
Continental Breakfast Wednesday, July 14, 8:00 a.m.
Luncheon July 14 Vegetarian Meal Requested
Vendor's Reception Wednesday July 14, 6:00 p.m.
Banquet Wednesday July 14, 7:00 p.m. Vegetarian Meal Requested
Continental Breakfast Thursday, July 15, 8:00 a.m.
Luncheon Thursday, July 15 Vegetarian Meal Requested