[Nfbk] 2016 NFB of Kentucky State Convention Pre-Registration Form
Todd E. Stephens
todde.stephens at windstream.net
Tue Aug 23 15:51:22 UTC 2016
Greetings Everyone,
Please find the pre-registration form for the NFB of Kentucky State
Convention directly below:
PRE-REGISTRATION APPLICATION
NFB of Kentucky State Convention
September 30, October 1st, & 2nd, 2016
This application should be completed and returned to Mike Freholm, 2012
Harris Way, Russell, KY 41169 no later than Monday, September 19, 2016.
Make your check or money order payable to NFB of Kentucky.
REGISTRATION ($15.00) TOTAL
Number_______
$________
Name(s)___________________________________________________
Address___________________________________________________
City______________________________State____Zip____________
Phone_____________________________
Luncheon and Banquet tickets are included in the price of registration for
those who are current members, and who have pre-registered by September
19th.
LUNCHEON Non-member
$18.00
Number Attending---______
Regular__________
Vegetarian________
Gluten Free_______
Banquet
Non-member $30.00
Number Attending _____-
Regular _________
Vegetarian_____
Gluten Free_____
CHILDCARE
NOTE: You must enroll your child(ren) by September 4, 2016. If we do not
have at least three (3) children committed to using childcare we will not be
able to offer the service. A $10 non-refundable payment must accompany this
form for each child you wish to register. Your money will be refunded if we
do not sign up at least three children.
CHILDCARE ($10)
Number of Children $_________
Child(ren) Name-------------------------------------------------
----------------------------------------------------------------------------
-------------------------------------
Parents Name___________________________
Phone Number___________________________
RAFFLE TICKETS ($10.00)
Number Sold_________
$__________
DONATION
$__________
TOTAL ENCLOSED
$__________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://nfbnet.org/pipermail/nfbk_nfbnet.org/attachments/20160823/272d8420/attachment.html>
More information about the NFBK
mailing list