Sandusky Fire Department

600 W. Market St.

Sandusky, OH 44870

Print out this Registration Form:

Conquering the Promotional Exam Seminar:

Name       ______________________________________________________________

Address   ______________________________________________________________

City           ________________________ State__________ Zip Code ________________

Phone #   __________________________

E-mail       __________________________

Signature ____________________________________________

Check _________  Money Order ____________

*** Please send this form along with payment to:

Sandusky Fire Department

600 W. Market St.

Sandusky, OH. 44870    ( Attention: Diane Mulvin)

*** If you provide an E-mail address we will send you a confirmation notice of the receipt of payment

Seminar Date:

Saturday, December 2, 2006

8:99 am - 1:00 pm