2023 West Virginia School Safety Conference Registration Please enable JavaScript in your browser to complete this form.Name *FirstLastAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone *School/County/Organization *Role *Date of Birth (Necessary If Seeking EMS or LE CEU Credit):I Will Pay *Purchase OrderCredit CardStripe Credit CardCardName on CardRegistration Cost for IndividualPrice: $ 600.00Non-RefundablePurchase Order Number if ApplicableSpecial Group Pricing I will purchase 5 tickets, and my group receive one free conference ticket - $ 0.00I will purchase 10 tickets, and my group will receive one free conference ticket and ticket price will be $550 per person - $ 4,950.00I will purchase 20 tickets, and my group will receive one free conference ticket and ticket price will be $500 per person - $ 9,500.00Please contact LeFlore Lucas at katherine.lucas@wvesc.org, or 304.766.0011, ext. 34.Submit