Page 4 - September Board Meeting Mailer_Fee Waived

NABCA SEPTEMBREReBgOisAtRrDatOioF DnIRFEoCrTmORS MEETING 2016

REGISTRANT NAME BADGE NAME

ORGANIZATION

ADDRESS

CITY, STATE, ZIP

TELEPHONE E-MAIL

ASSISTANT NAME ASSISTANT E-MAIL ASSISTANT TELEPHONE

SPOUSE NAME BADGE NAME

TELEPHONE SPOUSE E-MAIL

ITINERARY

(This information is crucial for food functions & rooming guarantees. Thank you for your cooperation.)

Registrant Arrival 9/_______ /16 _______ AM/PM Departure 9/_______ /16 _______ AM/PM

Spouse Arrival 9/_______ /16 _______ AM/PM Departure 9/_______ /16 _______ AM/PM

Yes, I will be attending the dinner in the Atrium on 9/18. Yes, I will be attending the dinner in the 5ive Restaurant on 9/19.

LODGING INFORMATION

NABCA has secured a room rate of $210.00 for single/double occupancy plus 10.5% room and occupancy tax. The room rate includes
complimentary high-speed Internet in guest rooms and access to the Sports Club.

Room Type: ____King ____Queen/Queen Other Requests:______________________________
REREGISTRATION FEE: $995.00 CHECK ENCLOSED (payable to NABCA) -or-
(including dietary restrictions or food allergies)

FEGISTRACREDIT CARD NUMBER
/ $
E W TIOPRINT CARDHOLDER’S NAME AUTHORIZED SIGNATURE DATE
A NNOTE: Due to new Payment Card Industry (PCI) compliance guidelines all payments with credit card information MUST BE

SUBMITTED VIA SECURE FAX to (703) 824-3377 or mail. NABCA can no longer accept emails that include credit card information.
EXPIRATION DATE AMOUNT

IVEDCONFIRMATION

Please note: You will receive a reservation confirmation email directly from the hotel. NABCA will send a second confirmation email with
further important details 1-2 weeks prior to the meeting.

CANCELLATION INFORMATION

All rooms are guaranteed for late arrival by NABCA. In order to avoid penalties, please notify NABCA 3 days prior to arrival of any cancellations
or changes in stay.

RETURN BOTH THE REGISTRATION FORM AND THE ACTIVITY FORM NO LATER THAN FRIDAY, AUGUST 26, 2016!

4401 Ford Avenue, Suite 700, Alexandria, VA 22302 • Secure Fax: (703) 824-3377
Contact the Meetings Department at (703) 578-4200 or meetings@nabca.org with any questions.