Niba

Thank you for registering for the upcoming NIBA Capital Conference. We look forward to having you join us at the Conference.  Please note that conference registration cancellations received 10 days prior to the conference will be credited to a future attendance. Attendees who cancel within 10 days of the conference will receive a credit that may only be applied to the next scheduled conference.  Registration fees must be paid in full prior to the conference.
 

Registration Form: (please, only one attendee per form)
Name:		Title:
Company:		Website:
Address:		Email:
City:		Correspondence:	Email	Fax
State:	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY	Phone:
ZIP:		Fax:

 

Select the pricing option below that applies to you:
REGISTRATION FEE (For NIBA Members/Associate Members Only)		$350.00	Yes	No
First Time New Member & Associates: 1/2 price (application must be submitted and approved)		$175.00	Yes	No
Early Registration (submitted by Oct. 15th) (For NIBA Members/Associate Members Only)		$295.00	Yes	No
Spouse/Companion Registration (This price does not apply to company personnel)		$100.00	Yes	No
VENDOR REGISTRATION FEE (This includes 6ft. skirted display table and 2 Co. Reps)		$1,000.00	Yes	No
GUEST FEE (all others, exludes presenting companies)		$475.00	Yes	No

 

Conference Registration Payment Method:
Charge My:	VISA      MasterCard      American Express       Check Enclosed (Made payable to NIBA)
Card Number:		Name on Card:
Expiration Date:		Billing ZIP Code: (for credit card)

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NIBA golf/polo shirts are in and available for order. Shirts come in navy with white logo, white with navy logo, and bimini blue with ivory logo and are available in sizes S, M, L, and XL for $25.00 each. Each shirt features the NIBA logo.
NIBA Shirt:	$25.00	Select Color Navy/White Blue/Ivory White/Navy	Select Size Small Medium Large Extra Large	Qty:	No, Thanks
Note: NIBA discourages conference participants from hosting activities that conflict with events scheduled by NIBA.

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HOTEL RESERVATIONS: (ONLY ROOMS RESERVED THROUGH NIBA WILL BE GUARANTEED AT THIS ROOM BLOCK RATE). Please fax your registration form to the NIBA Office at 706-208-1033.   THE WYNN HOTEL, 3131 LAS VEGAS BLVD. SOUTH, LAS VEGAS, NEVADA 89109
Room Type:	Single-$199.00 Double-$199.00 Tower King-$309.00 Tower Executive Suite-$425.00 Tower Parlor Suite-$550.00 Tower Salon Suite-$650.00
Arrival Date:		Departure Date:
Sharing with:		Hotel  Reward Number: (not required, optional)
Special Needs/ Accomodations:
Sharing with:		Hotel  Reward Number: (not required, optional)

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Hotel Payment Method:
Charge My:	VISA      MasterCard      American Express       Discover
Card Number:		Name on Card:
Expiration Date:		Billing ZIP Code: (for credit card)

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I understand all guaranteed reservations will be held until 6:00AM the following day. I understand that I am liable for one night's room deposit and tax (which will be deducted from my deposit or billed through my credit card) in the event that I do not arrive or cancel 72 business hours prior to the arrival date indicated.