Registration Information: Click here: Download PDF Registration for print
REGISTRATION INFORMATION
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| *Conference Registration for | Non-Member | Member | Senior Citizen/Student (proof ID) | Asterisk (*) Includes access to all conference, activities, | |||||||||||
| Early Bird by June 15th. | (see *) | $150 | $120 | $80 | breakfast and buffetlunch from Friday morning, | ||||||||||
| Between June 16th - August 31st | (see *) | $175 | $145 | $100 | October 5 through Saturday, October 6 and banquet/gala | ||||||||||
| After September 1st | (see *) | $200 | $175 | $120 | (dinner) on Saturday, October 6. | ||||||||||
| Gala Early Ticket Only | $60 | $50 | $50 | ||||||||||||
| Effective: Sept 12 - Gala Ticket Only | $100 | $80 | $80 | ||||||||||||
| Refund Policy: No Refund | |||||||||||||||
| Name:(last)__________________________________________ (first)______________________________________________ |
ALL CONFERENCE REGISTRATIONS MUST BE PREPAID. | ||||||||||||||
| JobTitle:____________________________________________ | Make registration payable to: NCHDHH Conference 2007 | ||||||||||||||
| Institution or Company: ________________________________ | by Money Order, or Personal Check ONLY | ||||||||||||||
| Department or Organization:_____________________________ | Mail to: | PO. Box # 91515 Washington, D.C. 20090 |
Fax: 410-674-7254 | ||||||||||||
| Mailing Address:_____________________________________ | HOTEL INFORMATION | www.kelloggconferencehotel.com | Hotel Reservations must be made on your own directly to the hotel | ||||||||||||
| City:____________ State:_________ Zipcode: ___________ | Kellogg Conference Hotel(Gallaudet University) | ||||||||||||||
| VP/TTY/Telephone #:_______________________________ | 800 Florida Ave, N.E. Washington, D.C. 20002-3695 | Telephone: (202) 651-6000 Fax: (202) 651-6107 |
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| E-Mail:___________________________________________ | Conference Room Rates: Reservation Code: SER or NCHDHH |
Singles: $130 | Triples: $139 |
Doubles: $130 | Quad: $159 | ||||||||||
| Special Needs (check below): The NCHDHH is committed to making their activities as accessible as possible to persons with disabilities or special needs. If you anticipate a need for other services, please email us at nchdhhconference2007@ldhhamdc.org | |||||||||||||||
| Spanish _____ | Please visit the website for more info: | ||||||||||||||
| Deaf Blind _____ | www.ldhhamdc.org/natconf07.html | ||||||||||||||
| Daycare: ($?), How many children? ____ please email us. | www.nchdhh.org | ||||||||||||||
| For Official Use Only: | _____ Paid | _____Incomplete | |||||||||||||