[Nfbk] 2016 NFB of Kentucky State Convention Pre-Registration Form

[George Stokes]

Thanks Todd

 

From: Nfbk [mailto:nfbk-bounces at nfbnet.org] On Behalf Of Todd E. Stephens
via Nfbk
Sent: Tuesday, August 23, 2016 11:51 AM
To: 'NFB of Kentucky Internet Mailing List'
Cc: Todd E. Stephens
Subject: [Nfbk] 2016 NFB of Kentucky State Convention Pre-Registration Form

 

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
$__________

 

 

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