CONFERENCE REGISTRATION FORM #1 by fno50308

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									                                         NAM Annual Public Affairs Conference
                                           The Ritz-Carlton Amelia Island
                                                 Amelia Island, FL
                                                 March 21-23, 2010

Please print or type (*=required)
 __________________________________________________________________________________________________________
  *Name                                                              Badge Name
____________________________________________________________________________________________________________________________________
  Title
____________________________________________________________________________________________________________________________________
  *Organization
____________________________________________________________________________________________________________________________________
  *Address
____________________________________________________________________________________________________________________________________
  *City                                                             *State                                *Zip
____________________________________________________________________________________________________________________________________
  *Phone                                                             Fax                             *E-mail
____________________________________________________________________________________________________________________________________
  Spouse/Guest Name (if attending)
____________________________________________________________________________________________________________________________________
  Additional Attendees
____________________________________________________________________________________________________________________________________
  Emergency Contact Name / Number(s)                                                                Special Dietary Needs / Requests

Registration Fees:                  $950.00 NAM Member                              $ ________________
                                    $850.00 Additional NAM Member                   $ ________________
                                    $1100.00 Non-Member                             $ ________________
                                    $1000.00 Additional Non-Member               $ ________________
                                    Yes, my spouse/guest will attend the The Ritz-Carlton Amelia Island Conference.
                                   Must sign up by March 1, 2010. Please select an option below.

Register now to take advantage of the early bird registration fees before the price increases on February 1, 2010.
Early Bird Fees:
                                   $900 for NAM members;
                                   $800 for additional registrants from same organization

                                   $1050 for non-members;
                                   $950 for additional registrants from same organization

Spouse/Guest Registration Options
        Sunday Reception & Dinner ($150)
        Monday Reception & Dinner ($175)
        Full Registration ($300) – includes all meals, functions and spa activity.
        Special Dietary Needs: _____________________________


Total Registration Fee:                                                               $_______________


A $100 service fee is applied to all conference cancellations. No refunds after March 5, 2010. Substitutions permitted at anytime.


    Mail form and check payable to NAM to: 1331 Pennsylvania Ave, NW, Suite 600, Washington, D.C. 20004-1790,
                                           Attn: Meetings Management



               For special assistance, whether physical or dietary, please call Abe Elmazahi at (202) 637-3116.

								
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