NYSAFC Company Officers Leadership Training (COLT)

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29 Οκτ 2013 (πριν από 4 χρόνια και 15 μέρες)

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NYSAFC Company Officers Leadership Training (COLT)
Program Pre-Registration Form
Registrant’s Information
Use one form per person. Confirmation will be mailed to address below.
Name: ______________________________________________ Title: ______________________________________________
Department/Organization: _________________________________________________________________________________
Address: _______________________________________________________________________________________________
City: _______________________________________________ State: _________________ Zip Code: ___________________
Daytime Phone: ( ) _____________________________ E-Mail: ____________________________________________
Program Dates / Locations

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Westchester County / December 6-7, 2013
Hilton Westchester • 699 Westchester Avenue • Rye Brook, NY 10573
Hotel Reservations: Rate: Single/Double $119 per night. Reservations: Call 800-HILTONS or go online to www.
hilton.com/en/hi/groups/personalized/R/RYEHIHH-NYSAFC-20131204/index.jhtml. Group Code: NYSAFC. Cut-off
date is November 5, 2013. Reservations received after this date will be accepted based on availability.

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Capital District / February 7-8, 2014
Hilton Albany • 40 Lodge Street • Albany, NY 12207
Hotel Reservations: Rate: Single/Double $135 per night. Reservations: Call 866-691-1183. Group Code: 1FIRE.
Cut-off date is January 16, 2014. Reservations received after this date will be accepted based on availability.

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Monroe County / April 4-5, 2014
DoubleTree by Hilton Rochester • 1111 Jefferson Road • Rochester, NY 14623
Hotel Reservations: Rate: Single/Double $129 per night. Reservations: Call 585-475-1510 or go online to http://
doubletree.hilton.com/en/dt/groups/personalized/R/ROCDTDT-CFC-20140404/index.jhtml. Group Code: CFC. Cut-
off date is March 27, 2014. Reservations received after this date will be accepted on space and/or rate availability.
Payment Information
Registration Fee: Includes three seminars (hotel not included).
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$150 NYSAFC Member / Per Person
NYSAFC Individual Member #: ______________________ OR NYSAFC Department Member #: ____________________
(Registrant must be an Individual NYSAFC Member or registrant’s department/organization must be a NYSAFC Department Member for
discount. Not sure of your membership status or number? Contact NYSAFC to confirm.)
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$175 Non-Member / Per Person
Method of Payment:
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Check (Made payable to NYSAFC)
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Voucher
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American Express
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Mastercard
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Visa
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Cash
Credit Card #: _________________________________________ Expiration Date: _______/ _______ CVN #: _____________
Name on Account: _______________________________________________________________________________________
Billing Address: __________________________________________________________________________________________
City: __________________________________________State: ________________________ Zip Code: __________________
Submit Pre-Registration Form & Payment to:
New York State Association of Fire Chiefs • P.O. Box 328 • East Schodack, NY 12063 • Fax: (518) 477-4430
Phone: (800) 676-3473 or (518) 477-2631 • E-Mail: education@nysfirechiefs.com • www.nysfirechiefs.com