NCALEEA, INC.
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ADVISOR REGISTRATION FORM - YEAR: 2020
NCALEEA AGENCY ADVISOR REGISTRATION FORM
I. Advisor Information
NAME ___________________________________POSITION IN POST __________________________________ (Advisor; Assistant Advisor; etc...)
E-MAIL : _________________________________________________ PHONE# ____________________
Registered/chartered with local BSA/ Learning for Life Office: YES _______ NO _______
Registered/chartered with Public Safety Cadets Organization: YES_______ NO_______
II. Agency Information
AGENCY:___________________________________*POST#:_________*LOCAL BSA COUNCIL:_____________________ *(IF CHARTERED WITH BSA/LEARNING FOR LIFE)*
AGENCY:___________________________________*UNIT#_________ *(IF CHARTERED WITH PSC)*
AGENCY ADDRESS: ____________________________________________________________________________ ______________________________________________________________________________________________
AGENCY PHONE#: ______________________ E-MAIL ADDRESS:___________________________
LEAD ADVISOR: ____________________________________PHONE: _________________(C)________________(W)
LEAD ADVISOR/E-MAIL _____________________________________________________________________
****************************************************************************************************************************************** ANNUAL POST/AGENCY FEE: $20.00
1. BRING REGISTRATION FORMS AND FEES TO THE ASSOCIATION MEETING ON FEBRUARY 24; or email Completed Form to STATE SECRETARY James J Flowers : [email protected]; SEND FEES TO: SERGEANT CH SLUDER-RETIRED, 1103 NEW HAMPSHIRE DRIVE , JAMESTOWN NC 27282,