PENNBOC REGION 1 EDUCATION REGISTRATION FORM

Attendee: ______

Date: December 10, 2015 Location: Willow Grove, Giant Food Store, 2nd floor , 315 York Rd., Willow Grove, Pa. 19090. Event: Residential Electric

Your currant E-mail must be noted below or insert a business card

E-Mail Address: ______A confirmation E-mail will be sent out on the Monday before the meeting.

Pennboc Members ; $25.00 Check # :______

This training is only offered to Pennboc members. Seating is limited Membership Application is found at Pennboc.org

Continuing Education Units: 6 hours Please make check payable to: PENNBOC Region 1 Mail fee to: Bruce Hentschel [email protected] (Include this form) Abington Township Building [email protected] 1176 Old York Rd. Abington, Pa., 19001 Registration and fee must be received by Friday, Dec.. 4, 2015 Pennboc business meetings begin at 8:00 AM. , Educational program follows at 8:30. Lunch cost is included in the fee. A certificate of attendance (recognized by the Pennsylvania U.C.C. & ICC) with the CEUs noted is issued at the conclusion of the training. Participant must stay for entire training to receive Certificate. Complete, Copy & Return this form with payment