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NAME: ______________________________
TITLE: ______________________________
AGENCY: ____________________________
POSTAL ADDRESS: ____________________
____________________________________
EMAIL ADDRESS: _____________________
PHONE: ____________________________
Current Member:____ FREE
New/Renewing: ____ $20.00
Non-Member Attendee: _____ $15.00
Lunch is provided. Please indicate any dietary
restrictions: ___________________________
_____________________________________
REGISTRATION DEADLINE -June 6, 2014
Make all checks payable to: VJJA.
Send registration form and payment to:
Virginia Juvenile Justice Association (VJJA)
Tammy Deihr, VJJA Northern District
c/o 15rd District Court Service Unit
PO Box 1122
Bowling Green, VA 22427
804-633-9340
northerndistricttraining@vjja.net or
tammy.deihr@djj.virginia.gov
Payment must accompany registration form. | 
