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NABCA JANUARY BOARD OF DIRECTORS MEETING 2016

             Registration Form

RESERVATION INFORMATION

R EGI STRA NT NAME							 BA D G E NA M E

O R G A N I Z AT I O N

ADDRESS

C ITY, STATE, ZIP

TELEPHONE	              	  	          	  	  	  	               	  E-MAIL

S P OUS E NAME								 BA D G E NA M E

TELEPHONE	              	  	          	  	  	  	               	  SPOUSE E-MAIL

ITINERARY	

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

Registrant	 Arrival 01/_______ /16 _______ AM/PM	                 Departure 01/_______ /16 _______ AM/PM

Spouse		                Arrival 01/_______ /16 _______ AM/PM	     Departure 01/_______ /16 _______ AM/PM

LODGING INFORMATION

NABCA has secured a special nightly room rate of $165.00 for single/double occupancy plus 12.05% state and local tax.
The room rate includes internet, local phone calls, access to fitness center and shuttle service to La Encantada Shopping
Center.

NABCA will arrange all lodging accommodations, so please indicate your preferences below.

Room Type:	                ____King	     ____Queen/Queen	         	 Other Requests:______________________________

							                                                    		     (including dietary restrictions or food allergies)

REGISTRATION FEE: $995  CHECK ENCLOSED (payable to NABCA) -or-                    

CREDIT CARD NUMBER					                                        EXPIRATION DATE	  	  				                   $

                                                                                                        AMOUNT

        PRINT CARDHOLDER’S NAME					AUTHORIZED SIGNATURE					DATE

   CONFIRMATION

     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 MONDAY, DECEMBER 14, 2015!

                             NABCA 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.
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