EMA Dinner Registrations
Please complete the following to register for the NPAECT Extra Mile Award DInner
May 14th, 2009 - 5:30-8:30 PM
Nick's Place, Edinboro
* Required
Name
*
Are you a current NPAECT member
*
Yes
No
Not sure my membership is current
Have you been nominated as a 2009 Extra Mile Award Winner?
*
Yes
No
Are you registering a guest (s)? If yes, please list their names. If no, please simply type No.
*
If you have specific dietary needs (ex: vegetarian), please indicates those needs below.