Page 9 - NAGC2020 Reimagined Site License Professional Development Brochure

REGISTER ONLINE: www.nagc.org | EMAIL REGISTRATION FORM TO: adriane@nagc.org OR USE ONE
MAIL TO: NAGC, 1331 H Street NW, Suite 1001, Washington, DC 20005 FORM PER
QUESTIONS? Call 202-785-4268 or email adriane@nagc.org PERSON

67th Annual Convention | November 12-17 , 2020

A TTENDEE INFORMATION

o I am a first-time attendee. o I am a presenter. o I wish to be excluded from exhibitor mailings.

First Name Last Name

Professional Title

School/Organization

Mailing Address: check o home work

City, State, ZIP Code

Phone: check o home work

Email: check o home work

PA YMENT METHOD:
CANCELLATION/CHANGE/
SUBSTITUTION POLICY: o Check/Purchase Order (attach with form)
No refunds will be provided after October o Mastercard o Visa o AMEX o Discover
1. Changes in attendees can be made
without charge.
Name on Card
PHOTO RELEASE:
Photographs and/or video footage taken at
NAGC events may be used for publicity on Billing Address
www.nagc.org, social media, or in print
publications. Registration grants City State ZIP Code
permission for NAGC to publish photos,
video, and/or comments of attendees,
unless a letter stating that registrant “does Card Number
not grant NAGC permission to use personal
image or likeness” accompanies
registration form. Exp. Date CVV #

I authorize NAGC to charge my credit card for $

Signature

#NAGC20 RegisterNo
www.nagc.org