2004 Legislative Conference On Line Registration Form

2004 Legislative Conference and Reception
Wednesday, May 12, McKimmon Center, N.C. State University campus, Raleigh

Picture of Marc Basnight
Sen.
Basnight

Rep.
Black

Rep.
Morgan

Rep. Daughtridge

Sen.
Hoyle

Rep.
Crawford

Sen.
Garrou

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Click here for a quick look at the conference agenda.

We're looking forward to seeing you at our annual Legislative Conference on Wednesday, May 12, beginning at 1 p.m. at the McKimmon Center in Raleigh. We also hope you spend a relaxing evening with lawmakers at our Legislative Reception that evening at the Capital City Club in downtown Raleigh from 5:30 to 7 p.m.

The cost to attend both the conference and the reception is just $100 for NCCBI members and $120 for non-members. Groups of five or more registering together for both the reception and the conference quality for a discount -- $75 for NCCBI members and $100 for non-members. For example, members of a local chamber of commerce could register as a group and carpool to the conference. The cost of attending the reception only is $40 for NCCBI members and $50 for non-members.

Please complete the form below to register for the conference and/or reception. If you have any questions about the event or need more information, call NCCBI at 919-836-1400, send us a fax at 919-836-1425, or write to NCCBI, PO Box 2508, Raleigh, N.C. 27602.

After completing the form, click the submit button at the bottom to send your registration to NCCBI. Thank you.

Directions to the McKimmon Center: From I-40 traveling east from the RDU airport area -- take Gorman Street Exit #295. Turn left onto Gorman Street. Go approximately 1 mile. McKimmon Center is on the right past Avent Ferry Road, before Western Boulevard. From I-40 traveling west -- take Gorman Street Exit 295. Turn right onto Gorman Street. Go approximately 1 mile. McKimmon Center is on the right past Avent Ferry Road, before Western Blvd.

Directions to the Capital City Club: From I-40 east or west, take Exit 298B onto South Saunders Street towards Downtown Raleigh. Go right at the fork, which is McDowell Street. Turn right onto South Street. Go 2 blocks and turn left onto Wilmington Street. Valet parking is available.

Conference Registration Form
Please type names as you prefer them on name badges

First Name:		Last Name:
Title:		Company Name:
Mailing Address:		Mailing Address:
City:		State: ZIP:
Telephone (Including Area Code) :		Fax (Including Area Code):
E-Mail Address:
Attendee 1 Name:		Attendee 2 Name:
Attendee 3 Name:		Attendee 4 Name:
Attendee 5 Name:		Attendee 6 Name:
Attendee 7 Name:		Attendee 8 Name:
Attendee 9 Name:		Attendee 10 Name:

Number of NCCBI member attendees @ $100 each		Total $ - NCCBI members
Number of non-member attendees @ $120		Total $ - non-NCCBI members
Number of NCCBI member attendees @ $75 each (minimum of five)		Total $ - Reception only NCCBI members
Number of non-member attendees @ $100		Total $ - Reception only non-NCCBI members
Number of reception-only NCCBI member attendees @ $40 each
Number of reception-only non-member attendees @ $50 each		Total cost of registrations:

Please choose one of the following payment types:
		I will mail in the amount by check Visa MasterCard AMEX
Credit Card #:
	Expiration Date:	-mm/dd/yy