N4A :: Regions :: Region V :: 2008 Region V Conference Registration Form

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2008 Region V Fall Conference
October 16-18, 2008
UNLV
Las Vegas, Nevada
Host Sponsor School: University of Nevada - Las Vegas

REGISTRATION FORM

* INDICATES REQUIRED FIELDS

First Name: *

Last Name: *

Professional Title:

Institution: 2-Year 4-Year Other

If Other, Please Specify:

Address: *

Phone Number: *

E-mail Address: *

Are you a New N4A member? (Joined after last convention in June 2008)? *

What is your membership status? *

Will you be attending the N4A Welcome Reception on Thursday, October 16, 2008? *
Will you be attending the UNLV-AFA Football game on Saturday, October 18, 2008? *

CONFERENCE REGISTRATION FEES

How will you be paying the registration fees? *

If you chose the PAYPAL option, Please click on the appropriate link below to complete your payment in a separate window via PayPal. If you are paying with a check, please scroll down to the
"Check Payment Option".

NOTE FOR PAYPAL PAYMENTS: Your registration will NOT be fully processed by the N4A National Office until you submit the PayPal payment via the instructions at the bottom of this form AND SUBMIT this form online.

PAYPAL PAYMENT OPTION
(You will be taken to a separate window to complete PayPal payment)
N4A Region V Conference Registration PayPal Page

Conference Fees
Early Registration Deadline has passed (DEADLINE - 10/03/08)
N4A/3C4A Members:

Registration ($80) Early Registration was ($60)
Non-Member ($100) Early Registration was ($75)

Student Members Options:

Registration ($60) Early Registration was ($40)
Non-Member ($75) Early Registration was ($50)

ADDITIONAL PAYPAL INSTRUCTIONS

Once you have completed your payment from the PayPal website, please complete your registration by following these instructions:

-Print 2 copies of this registration form. Either from this completed web form or from the submission e-mail which you will receive once you submit this form.

-Print out your PayPal receipt. This can be obtained from either the receipt PayPal e-mailed you or from logging into your PayPal account.

-Fax your PayPal receipt and a copy of this registration form to the
N4A National Office at 919-513-0541
All registrations must be accompanied by FULL payment.

CHECK PAYMENT OPTION

Please make checks payable to N4A

N4A Federal Tax ID#: 33-0222728

-Print 2 copies of this registration form. Either from this completed web form or from the submission e-mail which you will receive once you succesfully submit this form.

No Registration will be accepted until/unless it is accompanied by a check.

Send your check and 1 printed copy of your registration form(s) to the following address:

N4A National Office
Campus Box 8509
Raleigh, NC 27695-8509

PLEASE CLICK SUBMIT TO COMPLETE YOUR REGISTRATION.
YOUR REGISTRATION WILL NOT BE PROCESSED UNLESS YOU CLICK SUBMIT.
CLICK RESET TO RESET THIS FORM.

You should receive an e-mail with your registration information.
Please keep it for your records.
Also, you MUST print your copies of this form before clicking SUBMIT.

Thank you for registering for our 2008 Region V Conference!
We look forward to seeing you in Las Vegas!