National Federation of the Blind of Colorado

2009 NFBCO ANNUAL STATE CONVENTION

ONLINE PREREGISTRATION FORM

Thank you for preregistering for the Convention. Remember, at Convention the fee for registration will be $20 and the banquet ticket will cost $40. Friday and Saturday luncheons will be $20. So when you register early and purchase your banquet and luncheon tickets YOU SAVE $25!

* Denotes required field

Please complete and submit this form before Sunday, October 25th.

First Name *	If paying by credit card, your name must match your name exactly as it appears on the card.
Last Name *
Address *	If paying by credit card, this address must match the billing address for the card.
City *
State/Province *
Zip *
Home Phone *
Alternate Phone : *
Email Address *
Verify Email Address *
Please indicate your preference for picking up your packet by selecting one of the following:
I will pick up my registration packet at convention
The following person will pick up my registration packet at convention	Pick-up Person's Full Name:
Please register yourself first, then you will be prompted to register additional attendees if you wish to pay for multiple registrations with one transaction. Payment is accepted by credit card, money order or check. Note that all preconvention registration, luncheon, and banquet sales are final!
Register for all Events	$85.00 total registration cost/registration for all events
2009 Convention	$15.00
Thu, Nov 5 A Fair for All	$10.00
Fri, Nov 6 Luncheon	$15.00
Sat, Nov 7 Luncheon	$15.00
Sat, Nov 7 Evening Banquet	$30.00
Check this box if you would prefer a vegetarian meal:

Payment Method: *
NFBCO accepts Visa, Mastercard, Discover or American Express

Number of Additional Attendees you will be registering:
* (not including yourself)

After you have entered all the attendees you wish to register, if you selected to pay via Credit Card, you will be redirected to a secure page with your total to enter your credit card information and finalize your registration. If you wish to send a check or money order by mail, the system will provide your total and details for mailing your payment once you have entered all attendees.

2233 W. Shepperd Avenue
Littleton, CO 80120
Phone: (303) 778-1130
Toll Free: (800) 401-4NFB
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