National Association
of County Veterans Service Officers

Conference Registration

I will be attending virtually.:

Yes
No

^*First Name:

^*Last Name:

^*Your Position:

^*Office Name:

^*Mailing Address:

^*City:

^*State:

-- Select a State -- Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota North West Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming Yukon Territory

^*Zip Code:

^*County Name:

^*Phone:

^*Email:

^*You are a::

CVSO
State Service Officer
Other (provide explanation)

^*Fee:

-- Select One -- Member $350.00 Non-Member $500.00

^*Share your contact info with conference sponsors?:

Yes
No

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^*Emergency Contact name and phone number: