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THE MUNICIPAL ELECTRICAL INSPECTORS
ASSOCIATION OF N.J., INC.
Seminars Start Date To Be Determined Seminar Locations in Monmouth & Ocean County
No Applications will be accepted after March 31, 2011
Coffee and Refreshments will be provided at the seminar locations.
PLEASE PRINT ALL INFORMATION CLEARLY IN SPACES PROVIDED BELOW
Name ____________________________________________________ License # _____________
Address __________________________________________________ BP # _________________
Town _________________________ State _____ Zip Code ________ Phone # ____-____-_______
I have read the application and I understand that my signature below confirms my agreement to attend the scheduled classes. I also understand that NJMEIA is not obligated, should I fail to attend the required classes, to provide any additional classes for my benefit.
Signature ____________________________________________________ Date ______________
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