Registration

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.

General Info Full Name: Title: Company: Address: Address 2: City: State: Zip: Phone: Fax: E-mail: Verify EmailAddress: Website: Conference Registration Fee (Per Person): $350.00 Early Registgration Fee ($295.00) (Applies if received by August 10, 2008) NON Broker/Dealer ($475.00) New member/associate member 1st time conference attendee ($175.00) Special offer code:

Credit Card Info Spouse or companion attending Name: Spouse/Companion Registration ($100.00) Paying by: Card Number: Expiration date: mm/yyyy

Hotel Information Arrival date: Departure date: Single Room ($209) Diplomat suite ($309) Club suite ($359) Corner suite ($409) Sharing with: Special Needs:

Niba

Connecting Companies with Funding and Liquidity Sources Since 1982.

Registration