REGISTRATION FORM

FREE* Basic 30-Hour and Advanced Accident Prevention Certificate Awareness Programs
Presented by N.C. Industrial Commission Safety Education Section
October 26-30, 2009
at the
 North Carolina Zoo
 Stedman Education Center
4401 Zoo Parkway
Asheboro, NC 27205

*There will be a $4.00 per person charge, payable at the workshop,
to cover the defensive driving course book.

There are two ways to register:

  1. Print out and fill in the REGISTRATION FORM FOR ASHEBORO APCAP COURSES and mail or fax it to:

N.C. Industrial Commission Safety Education Section
4339 Mail Service Center
Raleigh, NC 27699-4339
(919) 807-2603, Fax: (919) 715-6573
ATTENTION: DENNIS PARNELL

  1. Register online via the E-MAIL REGISTRATION FORM FOR ASHEBORO APCAP COURSES.

Note: The Quality Inn is offering a rate of $63.75 per night, plus tax, for the Asheboro APCAP. Please make hotel reservations directly with the Quality Inn, 242 Lakecrest Road, Asheboro, NC 27203; (336) 626-3680. When making reservations, please mention NCIC, which is the Promotion Code for special room rates!

N.C. Industrial Commission ·   Safety Education Section
4339 Mail Service Center ·   Raleigh, NC 27699-4339
Telephone: (919) 807-2603 ·   Fax: (919) 715-6573
NCIC Home Page: http://www.ic.nc.gov//