PRE-REGISTRATION FORM
Convention Fees: Due by June 16, 2006
Name______________________________
Phone______________________________
Address____________________________
City_______________________________
State______________Zip Code_________
Fax________________________________
E-Mail_____________________________
REGISTRATION
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*Includes:
- Full PackageWorkshops & Plenary sessions
- Lunches (2 days)
- Cultural program & Banquet
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**Includes:
- Workshops & Plenary sessions only
- Lunch extra
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***Includes
- Workshops & Plenary session
- Lunch (2 days)
Please Note:
A $25 fee will be charged for any & all returned checks.
*Check Paid Item
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| Member (per Person)* |
$125.00 |
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| General (per Person)* |
$ 75.00 |
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| Student Registration per Person (ages 1321)* |
$ 75.00 |
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| Banquet Saturday |
$35.00 |
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| Concert Friday |
$15.00 |
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| Vendor** |
$150.00 |
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Due by June 16, 2006 ($25 additional afterwards).
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| Limited space available: |
| includes Friday & Saturday (one table & two chairs) |
Total Amount Submitted $ _______
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**Vendors:
CASHIERS CHECKS
or MONEY ORDERS ONLY!
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Forward this form by June 16, 2006
along with your Check or Money Order
payable to:
NBUF Educational Fund
12817 Ashland Avenue
Calumet Park, Illinois 60827
*After the June 15th deadline, pay an additional $25.00.
HOTEL:Mount Vernon
24 West Franklyn St.
Baltimore, Maryland 21201
(410 727-2000 or (800) 245-5256
- Single & Double: $99.00* per night
(includes daily contenental breakfast)
*Add 12.5% tax (total) per room, per night
- Hotel reservation deadline is Tuesday, June 13, 2006
Spaces are limited. Please make your reserverions early
and mention that you are with the NBUF Convention.
- Transportation is NOT available between hotel site & airport.
For additional convention information call:
(708) 389-9929
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