2011 Workshop Registration

Workshops are free - seats may be limited based on number of registrants and capacity.
Everyone registering MUST attend the 1:00 - 3:00 p.m. session.
The 10:30 a.m. session is optional, meant for those local governments who are new and have not completed the required participation forms or those who have been recently assigned the duties of debt setoff. However, those currently participating are still welcome. There is always plenty of room for this session.
please register your vendor/third-party administrators that will be attending.
For more than 5 attendees, please complete a separate registration form.
For changes or cancellations once submitted, send an email to ncsetoff@ncsetoff.org, no need to re-do entire registration form.

Required Information - #1 - 7

1. Local Government Name
2. Type	City/Town County or County Department Water & Sewer Auth. (Ch. 162A Art. 1) Joint Regional Agency (Ch. 160A Art. 20) Public Health Authority (Ch. 130A Art. 2) Metro. Sewerage Dist. (Ch. 162A Art. 5) Sanitary District (Ch. 130A Art. 2) Housing Authority (Ch. 157)
3. What is the status of your Local Government with the Debt Setoff Clearinghouse?	Active (currently submitting debts) Inactive (submitted forms but not debts) New (no forms or debts submitted)
4. Have you ever attended a Debt Setoff Clearinghouse Workshop?	Yes No
5. Location	a) Hendersonville - CLOSED) b) Hickory - (CLOSED) c) Albemarle - (CLOSED) d) Raleigh (CLOSED) e) Wallace (CLOSED) f) Washington (CLOSED)
6a. Session	a) 10:30 - 11:30 a.m. (OPTIONAL) b) 1:00 - 3:00 p.m. (MANDATORY) d) Both sessions
6b. 10:30 - 11:30 a.m. Optional Session Reason	Never been before Attended before - need a refresher course Debt Setoff is/will be a new responsibility
7a. Name
7b. Email Address
7c. Department
7d. Job Title or Description
7e. Phone Number
8a. Name of Attendee #2
8b. Email Address of Attendee #2
8c. Department of Attendee #2
8d. Job Title or Description of Attendee #2
9a. Name of Attendee #3
9b. Email Address of Attendee #3
9c. Department of Attendee #3
9d. Job Title or Description of Attendee #3
10a. Name of Attendee #4
10b. Email of Attendee #4
10c. Department of Attendee #4
10d. Job Title or Description of Attendee #4
11a. Name of Attendee #5
11b. Email of Attendee #5
11c. Department of Attendee #5
11d. Job Title or Description of Attendee #5

2011 Workshop Registration

Workshops are free - seats may be limited based on number of registrants and capacity.

Everyone registering MUST attend the 1:00 - 3:00 p.m. session.

please register your vendor/third-party administrators that will be attending.

For more than 5 attendees, please complete a separate registration form.

For changes or cancellations once submitted, send an email to ncsetoff@ncsetoff.org, no need to re-do entire registration form.