2015 TRINITY EMS EMERGENCY SERVICE CONFERENCE

Christiana Fire Company Station 12

2 East Main Street, Newark, DE  19702

Saturday   2/21   0800 -- 1600 hrs. 

Sunday     2/22   0800 -- 1600 hrs.

Lunch will be provided.  Each day is good for 6 CEUs.

Payment is required at time of registration.  Acceptable forms of payment are cash, money order, business check, Visa, MasterCard or Discover.  

Please call (302) 223-5315 for payment arrangements or to use PayPal, go to www.emsdoneright.com and select 2015 Fire EMS Conference and Admission & Registration.

If you select Bill Fire Company/Employer and your Fire Company/Employer denies authorization/payment you will be financially responsible for payment. 

Registration Before 2/13/15:

1 Day Pass -- $55.00

2 Day Pass -- $110.00

Registration After 2/13/15:

1 Day Pass -- $80.00

2 Day Pass -- $160.00

FIRST NAME	*
LAST NAME	*
PAYMENT METHOD	*	BILL FIRE COMPANY BILL EMPLOYER SELF-PAY
AFFILIATION/EMPLOYER	*
APPROVING INDIVIDUAL	*
EMAIL	*
PHONE NUMBER	*
MAILING ADDRESS	*
CITY	*
STATE
ZIP CODE
Individual Rate Admission Passes		1 Day Pass -- $55.00 2 Day Pass -- $110.00 1 Day After 2/13/15 -- $80.00 2 Day After 2/13/15 -- $160.00
Security Code	*
COMMENTS/NOTES