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  REGISTRATION FORM

TAX COLLECTORS CERTIFICATION CLASSES

FALL  2009

NAME:________________________________________________________________ 

TITLE:________ ________________________________________________________

MUNICIPALITY:________________________________________________________

MAILING ADDRESS:____________________________________________________

_____________________________________________________________________

DAYTIME PHONE:______________________________________________________

EMAIL: _______________________________________________________________

Please check which class you will be attending:

C.C.M.C. 1A – Thomaston  ________

C.C.M.C. 1B – Tolland  ________     

C.C.M.C. II – Berlin ________     is this your last class?  Y / N 

** PLEASE NOTE THE CHANGE IN CONTACT PERSON for class registration!    You may mail or fax your registration to: 

DENISE RICE, CCMC

Tax Collector, Town of Salisbury

P O Box  338

Salisbury, CT  06068

      Phone:  860-435-5189      email:  saltaxcollector@yahoo.com

      Fax:  860-435-5172 (it is not necessary to follow your fax with a phone call)

       Make checks payable to:  Certification Committee

or to:  Certification Committee, Connecticut Tax Collectors’ Assoc., Inc.