CFPI Registration Form

20th Annual Fire Prevention Workshop

March 15-19, 2010
www.firepreventionofficers.org
Name___________________________________________________________________________________
Work Address_________________________________________________________________
City, State, Zip________________________________________________________________
Work Phone__________________________ Fax________________________________
Fire Dept./Company____________________ Email Address ___________________________
FULL WEEK ATTENDANCE / MONDAY-FRIDAY
Includes lunches (Monday through Thursday), all Workshop sessions, and Thursday Night Installation Banquet
$300.00 Prior to January 31, 2010 $350.00 February 1, 2010 and after $
SINGLE DAY ATTENDANCE
$100.00 per day, per person (Single day attendance includes lunch does not include Thursday banquet ticket)
Please circle the day(s) selected Mon. Tues. Wed. Thurs. $
INSTALLATION BANQUET
Installation of incoming California Fire Prevention Officer Board Members, Semi-Formal Attire
*Included in Full Week Purchase $50.00 per person otherwise $

I require a Invoice  Total Amount Enclosed $

Method of Payment:  Cash  Check  Money Order  PO #

 Credit Card (Visa and MasterCard Only): Provide the following information:
Acct # Name on card: Expiration Date:

Fill out registration form & class sign up sheets and return both with your payment to:

Penni Overstreet-Murphy, CFPI Chairperson

C/O San Bernardino County FD Make Checks Payable to: CFPI
620 South “E” Street
San Bernardino, CA 92415-0179

Personnel needing an invoice before payment must request an invoice when mailing or faxing registration
form. All payments must be received by March 1, 2010.
California Fire Prevention Institute is a Non-Profit Organization # 95-4833927
For Additional Information Call:
Penni Overstreet-Murphy (909) 386-8472 Rick Rodewald @ rickr@ucsc.edu
Fax # (909) 386-8460
Poverstreet-murphy@sbcfire.org
Refund Policy. Registration cancellation refunds are not permitted 3 days before the workshop. 50% refunds for registration
cancellations are authorized two weeks prior to the workshop. 90% refunds are available up to one month prior to the
workshop.