Economic Development Registration

Please fill out the following form and an ElectriCities training representative will contact you to complete your registration. All fields are required.

YOUR NAME
JOB TITLE
CITY/TOWN
YEARS OF EXPERIENCE
ADDRESS LINE 1
		Street address, P.O. box, company name, c/o
ADDRESS LINE 2
		Apartment, suite, unit, building, floor, etc.
CITY
STATE
PHONE
FAX
E-MAIL
		ex: john@mycompany.com
COURSE DATE
		MM/DD/YYYY (ex: 03/20/2004)
COURSE TITLE		Please select your course Economic Development 101 Incentives for Economic Development North Carolina Territorial Assignment Law Rate Tools for Recruitment and Retention Financial Tools and Alternatives
MEMBERSHIP STATUS		Dues paying member Associate member Other