Page 1 2017. ANNUAL CONFERENCE REGISTRATION FORM ...
OPTIONAL EVENT (Primary Attendee Only) The following optional event is not included in the full conference registration fee and requires a separate fee. Please check if you are planning to attend this optional event.
THURSDAY, APRIL 18 7 :00 a.m.
D
Golf Tournament at Mirimichi Handicap (or average 18-hole score) _______ Handicap may require verification by golf professional
D
Broker - $125
D
Funder/Associate - $125
(Golf registrations must be received by April 13, 2017. No refunds for golf cancellations will be made after that date.)
SUMMARY OF PAYMENT All registrations must be received no later than April 20, 2017. After this date, you must register on-site. Sorry, NAELB cannot bill you. All fees must be paid in advance and accompany this registration form. An electronic confirmation will be sent to you once your payment has been processed. Primary Attendee Conference Registration Fee
$ ____
_ __
Spouse/Guest Registration Fee
$ ____
_ __
Optional Events Fee
$ ____
_ __
Total conference fees due to NAELB
$ ____
_ __
D Check payable to NAELB enclosed. Please charge my credit card:
D American Express
D MasterCard
D Visa
Exp. Date _____ _ Card Number ---- - - - - - - ------- - - - - - ----_ __ Security Code _____ _ Signature ----- - - - - - - ------- - - - - - --_ __
CANCELLATION POLICY Written notice of cancellation must be received at NAELB Headquarters no later than Thursday, April 6, 2017 in order to receive a
refund, less a $75 processing fee. There will be no refunds for cancellations received after this date. All refunds will be processed after
the conference.
HOW TO REGISTER No phone registrations accepted. Complete all information and send form to: NAELB Headquarters I 326 E. Main St. I Louisville, KY 40202
Phone: (800) 996-2352 I Fax: (87 7) 875-4750 I Email: [email protected]
PHOTOGRAPHY RELEASE
D
Check here if you DO NOT give NAELB permission to use your image from conference photographs.
EMERGENCY CONTA CT Please provide the following information in case of an emergency. Name_ _ _ _ _ _ _ _ _______ _ _ _ _ _ _ _ _ _______ _ _ _ _ _ _ _ _ _______ _ _ _ __ Daytime Phone _________________ Evening Phone___________________ _
QUESTIONS? Call NAELB Headquarters at 800-996-2352. For additional hotel reservation information, please call the Sheraton Memphis Downtown Hotel at 901-527-7300 and identify yourself as a NAELB attendee.
ooe
NAELB Headquarters I 326 E. Main St. I Louisville, KY 40202
Phone: 800-996-2352
I
Fax: 877-875-4750
I
Email: [email protected]
THURSDAY, APRIL 18 7 :00 a.m.
D
Golf Tournament at Mirimichi Handicap (or average 18-hole score) _______ Handicap may require verification by golf professional
D
Broker - $125
D
Funder/Associate - $125
(Golf registrations must be received by April 13, 2017. No refunds for golf cancellations will be made after that date.)
SUMMARY OF PAYMENT All registrations must be received no later than April 20, 2017. After this date, you must register on-site. Sorry, NAELB cannot bill you. All fees must be paid in advance and accompany this registration form. An electronic confirmation will be sent to you once your payment has been processed. Primary Attendee Conference Registration Fee
$ ____
_ __
Spouse/Guest Registration Fee
$ ____
_ __
Optional Events Fee
$ ____
_ __
Total conference fees due to NAELB
$ ____
_ __
D Check payable to NAELB enclosed. Please charge my credit card:
D American Express
D MasterCard
D Visa
Exp. Date _____ _ Card Number ---- - - - - - - ------- - - - - - ----_ __ Security Code _____ _ Signature ----- - - - - - - ------- - - - - - --_ __
CANCELLATION POLICY Written notice of cancellation must be received at NAELB Headquarters no later than Thursday, April 6, 2017 in order to receive a
refund, less a $75 processing fee. There will be no refunds for cancellations received after this date. All refunds will be processed after
the conference.
HOW TO REGISTER No phone registrations accepted. Complete all information and send form to: NAELB Headquarters I 326 E. Main St. I Louisville, KY 40202
Phone: (800) 996-2352 I Fax: (87 7) 875-4750 I Email: [email protected]
PHOTOGRAPHY RELEASE
D
Check here if you DO NOT give NAELB permission to use your image from conference photographs.
EMERGENCY CONTA CT Please provide the following information in case of an emergency. Name_ _ _ _ _ _ _ _ _______ _ _ _ _ _ _ _ _ _______ _ _ _ _ _ _ _ _ _______ _ _ _ __ Daytime Phone _________________ Evening Phone___________________ _
QUESTIONS? Call NAELB Headquarters at 800-996-2352. For additional hotel reservation information, please call the Sheraton Memphis Downtown Hotel at 901-527-7300 and identify yourself as a NAELB attendee.
ooe
NAELB Headquarters I 326 E. Main St. I Louisville, KY 40202
Phone: 800-996-2352
I
Fax: 877-875-4750
I
Email: [email protected]
