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North Carolina Housing

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Fair Housing Training Registration

First Name (Required)

Last Name (Required)

Organization (Required)

Mailing Address (Required)

City (Required)

State (Required)

Zip (Required)

Phone (Required)

E-Mail (Required)

Are you currently a member? (Required)

yes no

Do you want to become a member?

yes no

Amount Paid (Required)

Please specify the amount paid:

$20 (NCHC Members)
$30 (Non-Members)

Location (Required)

Please select which training you will attend:

Raleigh - 9/14/07
Asheville - 10/26/07
Winterville - 11/02/07

Enter the word below (Required)

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