REGISTRATION FORM

FREE* 30-Hour Accident Prevention Certificate
Awareness Program
Presented by N.C. Industrial Commission Safety Education Section

 February 18-22, 2008
at the
Manteo Airport Pavilion
410 Airport Road
Manteo, NC 27954
 

 

INSTRUCTIONS: Fill out and click the Send E-mail button below to send in the following form.  Your email server will open with a new email.  Click send within your email program to submit the registration.  
 

 

E-MAIL REGISTRATION FORM FOR 30-HOUR APCAP

First Name:                                

Last Name:               
 

Position:                   
 

Company:                 
 

Address:                    
 

City:                                State:       ZIP: 

Phone:                  

E-mail Address:        
 

   Please check box to be added to e-mail list.

Note: There are two hotel options for the Manteo APCAP.  The Elizabethan Inn, 814 Hwy 64, Manteo, NC  27949; (252) 473-2101 is offering a rate of $59.99 per night, plus tax. The Elizabethan Inn is the closer of the two hotels, but does not offer internet services.  The special rate cut off is January 17, 2008. 

The Comfort Inn South Oceanfront, 8031 Old Oregon Inlet Road, Nags Head, NC 27959; (252) 441-6315 is offering street side rooms at $59.49 per night, Bayside at $67.99 per night and Oceanfront at $76.49 per night.  This hotel is located on the other side of the causeway approximately 15 mins. away.  The rate cut off is January 28, 2008.

Please make hotel reservations directly with the Elizabethan Inn or Comfort Inn. When making reservations, please mention NCIC, which is the Promotion Code for special room rates!

*$4.00 per person cost to cover defensive driving
course book is payable at the workshop.

N.C. Industrial Commission ·   Safety Education Section
4339 Mail Service Center ·   Raleigh, NC 27699-4339
Telephone: (919) 807-2603 ·   Fax: (919) 715-0282
NCIC Home Page: http://www.comp.state.nc.us/