REGISTRATION FORM
VHIA HOMICIDE TRAINING SYMPOSIUM
(Final details are being worked out)

NAME:__________________________________________

TITLE:__________________________________________

AGENCY:________________________________________

ADDRESS:_______________________________________

TELEPHONE: (___ ) ____________________

EMAIL ADDRESS: _________________________________

Are you a member (Y-N)
($200.00 for members/$250.00 non-members)

Will you be presenting a case (Y-N) Contact Dave Watson via email at VHIA1@aol.com or Rich Leonard via email at rleonard@co.stafford.va.us if you intend to present a case at the symposium

Will you be bringing a guest for lunch (Y-N)?
($15.00 per person per lunch)

Will you be bringing a guest for the banquet (Y-N)?
($30.00 per guest)

Please make checks payable to VHIA and send check, along with completed registration form, to VHIA, P.O. Box 317 , Woodbridge, VA 22191

Note: A letter of intent, on your department letterhead and signed by an authorizing party of your department will be accepted if you intend to pay at the door.  The "Letter of Intent" will be considered binding.

Note: Early registration will be honored up to and including September 21, 2008 . After that date the fee will increase to $225.00 for members and $275.00 for non members.