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NIAs 52nd Annual Convention Registration Form

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NIAs 52nd Annual Convention Registration Form Powered By Docstoc
					                                             NIA’s 52nd Annual Convention Registration Form
                                                                                                          (One Form Per Registration Party Please)

                                                                             March 28-31, 2007 • Sheraton Wild Horse Pass, Phoenix, Arizona
                         Educate to Ensure Success
                          Sheraton Wild Horse Pass Phoenix                       To register online, visit www.insulation.org/convention


                     REGISTRATION INFORMATION                                                      (please print or type)

                     Registrant Name: ________________________________________________Badge Name: ______________________________________________
                     Spouse/Guest Name: ______________________________________________Spouse/Guest Badge Name: __________________________________
                     Youth Name(s): __________________________________________________Youth Badge Name(s): ______________________________________
                     Company Name: __________________________________________________________________________________________________________
                     Company Address: __________________________________________________________________________________________________________
                     Phone: ______________________________Fax: ________________________________Arrival/Departure Dates: ____________________________
                     E-mail Address: __________________________________________________________________________________________________________
                     Home Address: ____________________________________________________________________________________________________________
                     First convention?                   ❑ yes ❑ no
                     REGISTRATION FEES
 MEMBER (NIA/TIAC)




                                                                                                                     Early Bird Plus                  Early Bird       Standard Registration              Total
                                                                                                                       (Through Jan. 31)               (Feb. 1–22)             (After Feb. 22)
                     Contractor/Distributor/Fabricator/Laminator                                                             $714                         $790                     $850                __________
                     Manufacturer/Manufacturers Rep.                                                                         $919                         $990                    $1050                __________
                     Spouse/Guest (Defined as someone accompanying a paid registrant who does                                $600                         $600                     $600                __________
                     not work in the industry and will not be attending business or committee meetings.)
                     Youth (Ages 3 to 18)                                                                                    $350                         $350                     $350                __________


                                                                                                                     Early Bird Plus                  Early Bird       Standard Registration              Total
                                                                                                                       (Through Jan. 31)               (Feb. 1–22)             (After Feb. 22)
NON-MEMBER




                     Contractor/Distributor/Fabricator/Laminator                                                            $1199                        $1299                    $1399                __________
                     Manufacturer/Manufacturers Rep.                                                                        $1499                        $1599                    $1699                __________
                     Spouse/Guest (Defined as someone accompanying a paid registrant who does                                $665                         $665                     $665                __________
                     not work in the industry and will not be attending business or committee meetings.)
                     Youth (Ages 3 to 18)                                                                                    $419                         $419                     $419                __________

                     Add $100 per person to the standard registration rate for registrations received after March 21, including on-site registrations.
                     Convention registration fee includes: 3 full dinners, 3 nights of entertainment, all business sessions, and all spouse/guest activities.
                     Please contact the Sheraton directly for room reservations by calling 602-225-0100, and mention that you are attending the National Insulation Association’s convention at the Sheraton Wild Horse Pass.
                     Reservations may also be made online at www.starwoodmeeting.com/book/insulation. Discounted room rates are $275 plus tax, per night, single or double occupancy. Please see additional reservation details on
                     pg. 2. These rates are available until February 28, 2007.

                     OPTIONAL REGISTRATIONS:
                     Shotgun Golf (March 30)                    $249 per player (includes box lunch) ____
                                                                Player ______________________________________ Golf handicap__________
                                                                Player ______________________________________ Golf handicap__________                                          Total Shotgun Golf Player Fees $ _________

                     Callaway rental golf clubs are available for $50 and must be prepaid to the golf course. Please contact Jon Bushnell, jbushnell@troongolf.com, for club rental.
                     Want to register a foursome? Contact NIA directly.
                     2007 Greg Norman              $55 each. Features course and NIA logos. All golf-shirt orders must be placed by February 28.
                     Brand Golf Shirts in “Nectar” Please indicate quantity and size: S________, M________, L________, XL________, XXL________Shirt(s)                                    Total Golf Shirt Fees $_________
                     Spouse/Guest Programs (Preregistration is required for both spouse programs. There is no additional fee for registered spouses/guests to attend either of these two programs.)
                     The Splendor of the Wrigley Mansion (March 29) Attendee Name
                     The Power of Hatha Yoga (March 30) Attendee Name

                     TOTAL AMOUNT ENCLOSED WITH REGISTRATION FORM                                                                                                                                $
                     Payment Method:               ❑ Check ❑ MC ❑ VISA ❑ AMEX                        Card #     ________________________________ Exp. ____/____ Signature ________________________
                     Registration Policies
                     Payment must accompany registration form. Make checks payable to: NIA, 99 Canal Center Plaza, Suite 222, Alexandria, VA 22314.
                     Refunds: All refund requests MUST be made in writing. Refunds will be disbursed in the following manner: Before and including February 22, 2007—full refund. After February 22—50% registration fee refund-
                     ed. After March 7—25% registration fee refunded. After March 21—no refund available. Golf Tournament Fees Refunds: Full refund available until March 1, 2007. After March 1, there will be NO tour-
                     nament refunds. Questions? Call NIA at 703-683-6422, fax 703-549-4838, or check our website at www.insulation.org. Online registration and credit card processing is also available at www.insulation.org/
                     convention.
                     ❑ Check here if you have a disability and may require additional accommodation to fully participate. An NIA staff member will contact you to make the appropriate accommodations.

				
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