2022 Virtual Workshop Registration (Required)

Workshop is free - capacity may be limited based on registrants and Zoom licenses.
There is only one session: Counties, Agencies, Municipalities and Housing Authorities.
The session is 2 hours, 9:30 - 11:30 a.m.
It is the exact same presentation as the six attendee workshops being held in October.
Client software is not covered in this workshop, there is a separate 1 and 1/2 hour virtual workshop on november 30.
For more than 5 attendees, please complete a separate registration form.
For changes or cancellations once submitted, send an email to customerservice@ncsetoff.org, no need to re-do entire registration form.

Required Information - #1 - 5

1. Local Government Name
2a. Type	City/Town County or County Department Water & Sewer Auth. (Ch. 162A Art. 1) Joint Regional Agency (Ch. 160A Art. 20) Public Health Authority (Ch. 130A Art. 2) Metro. Sewerage Dist. (Ch. 162A Art. 5) Sanitary District (Ch. 130A Art. 2) Housing Authority (Ch. 157) Regional Solid Waste Management Authority (Ch. 153A Art. 22) Vendor/Third-party administrator Other
2a. If Other, please specify
3. What is the status of your Local Government with the Debt Setoff Clearinghouse?	Active (currently submitting debts) Inactive (submitted forms but not debts) New (no forms or debts submitted)
4. Have you ever attended a Debt Setoff Clearinghouse Workshop?	Yes No
5. Session	Counties, Agencies, Municipalities, and Housing Authorities: Wednesday, November 2 (9:30 - 11:35 a.m.)

6a. Name
6b. Email Address
6c. Department
6d. Job Title or Description
6e. Phone Number
7a. Name of Attendee #2
7b. Email Address of Attendee #2
7c. Department of Attendee #2
7d. Job Title or Description of Attendee #2
8a. Name of Attendee #3
8b. Email Address of Attendee #3
8c. Department of Attendee #3
8d. Job Title or Description of Attendee #3
9a. Name of Attendee #4
9b. Email of Attendee #4
9c. Department of Attendee #4
9d. Job Title or Description of Attendee #4
10a. Name of Attendee #5
10b. Email of Attendee #5
10c. Department of Attendee #5
10d. Job Title or Description of Attendee #5