2015 Annual Meeting & Expo Registration Form Registration Information Name Company
Registration Fees Member/Affiliate/Associate
$845
______
Spouse/Guest*
$425
______
Address TOTAL ENCLOSED City/State/Zip Phone Number Fax Number
$ _________
*Fees apply to spouse, significant other or other nonsurety-industry-employed person who accompanies the registrant to the meeting. These categories do not apply to a second or subsequent registrant from your agency or company.
E-mail Address Home Address
Do you or your spouse/guest have any special needs to be accommodated? □ Yes □ No If “Yes” please describe:
Register online at www.nasbp.org or by sending this FORM and your CHECK to: NASBP PO Box 79954 Baltimore, MD 21279-0954 Make your check payable to NASBP. Credit card payments are only accepted with the online registration form. Registrant’s Name for Badge: _____________________________________________
_______________________________________ _______________________________________ _______________________________________ REGISTRATION CANCELLATION POLICY All cancellations must be sent in writing to NASBP at
[email protected]. For a full refund, a written cancellation must be received by March 18, 2015. Cancellations received between March 19 and April 3, 2015 are eligible for a 50% refund. Cancellations received after 5:00 pm on April 3 are not eligible for refunds. CREDIT CARD CANCELLATION POLICY
Spouse/Guest Name for Badge:____________________ _____________________________________________
When cancelling a registration paid for by credit card, all refunds will be issued by check only, a 5% processing fee will be deducted from the refund.
Continuing Education Session “Bond Claims – Shaken and Stirred” Presented by The Hartford
Please indicate the number of people attending each social event (Registered Attendees or Spouse/Guests Only)
Monday, April 20 (12:15 pm – 2:15 pm)
_____ Final Evening Awards Dinner
Pre-registration is required (check box below) □
CE Session Participation
_____ Spouse/Guest Event (Activity for Registered Spouse/Guests Only)