Name (as it should appear on your badge). Please print or type carefully. Please check all that apply: Member Member ⁭Board ⁭Member ⁭Non ⁭Speaker/Presenter ⁭Vendor Position Title Organization Mailing Address City State Zip Code ( ) ( ) Daytime Phone Evening Phone E-mail Address FULL MEETING ~ OCTOBER 3 5, 2012 FEE INCLUDES – PAYMENT RECEIVED BEFORE SEPT. 4 AFTER SEPT. 4 Wednesday ~ USNA Tour & Evening Reception Member Registration $400 $450 Thursday ~ Breakfast, Lunch & Dinner ⁭ ⁭ Non-Member Registration $465 $550 Friday ~ Breakfast & Lunch ⁭ ⁭ (Includes 1-year membership) 1-Day Only $200 $265 SPECIAL NEEDS ⁭ ⁭ Special Assistance on Site (please circle day) Thursday Friday ⁭ Special Dietary Needs ⁭ ADDITIONAL REGISTRANTS Other ⁭ Additional Lunch Day 1 ⁭$30 Additional Guest Lunch Day 2 Will you be touring the Naval Academy? ⁭$30 Additional Guest Event Dinner Bus leaves hotel at 2:15 P.M. on Wednesday, Oct. 3 ⁭$60 yes no ⁭ ⁭ TOTAL REGISTRATION FEE $
Name (as it should appear on your badge). Please print or type carefully. Please check all that apply: ⁭Board Member ⁭Member ⁭Non Member ⁭Speaker/Presenter ⁭Vendor Position Title Organization Mailing Address City State Zip Code ( ) ( ) Daytime Phone Evening Phone E-mail Address FULL MEETING ~ OCTOBER 3 – 5, 2012 FEE INCLUDES PAYMENT RECEIVED BEFORE SEPT. 4 AFTER SEPT. 4 Wednesday ~ USNA Tour & Evening Reception Member Registration ⁭ $400 ⁭ $450 Thursday ~ Breakfast, Lunch & Dinner Non-Member Registration ⁭ $465 ⁭ $550 Friday ~ Breakfast & Lunch (Includes 1-year membership) 1-Day Only ⁭ $200 ⁭ $265 SPECIAL NEEDS (please circle day) Thursday Friday ⁭ Special Assistance on Site ⁭ Special Dietary Needs ADDITIONAL REGISTRANTS ⁭ Other Additional Lunch Day 1 ⁭$30 Additional Guest Lunch Day 2 ⁭$30 Will you be touring the Naval Academy? Additional Guest Event Dinner ⁭$60 Bus leaves hotel at 2:15 P.M. on Wednesday, Oct. 3 ⁭ yes ⁭ no TOTAL REGISTRATION FEE $