**Please note that you will be charged for a no show
Name
Company
Email
Phone / Fax
Please fax your response to Kurt Treiber, Jr. at 203-294-2084 by Friday, January 6, 2012. Make yourcheck payable to CT PRIMA
c/o Kurt Treiber, Jr., Risk Manager, Town of Wallingford, 45 South Main Street, Wallingford, CT 06492.
You can also register online by visiting our website www.ctprima.org.
Any questions regarding this notice, please call
Kurt Treiber at 203-294-2130, or Cindy Bennett at 860-291-7244.