2004 Legislative Conference On Line Registration Form

Register to Attend the Annual Legislative Conference

NCCBI urges all members to attend the association's annual Legislative Conference that will be held Wednesday, May 12, 2004, at the Jane S. McKimmon Center on the N.C. State University campus. The Legislative Conference is increasingly regarded as the official kick-off of the legislative season. We also invite you to spend a relaxing evening with lawmakers at our annual Legislative Reception. There you will be able to share your personal concerns with legislators in one-on-one conversations in a friendly atmosphere. The reception will be held Wednesday evening, May 12, at the Capital City Club in downtown Raleigh.

The cost to attend both the reception and the conference is just $100 for NCCBI members and $120 for non-members. The cost for groups of 5 or more registering together for both the reception and the conference is just $75 each for NCCBI members and $100 each for non-members. If you wish to attend the reception only, the cost is only $35 for NCCBI members and $45 for non-members.

Please complete the form below to register for the Legislative Conference and/or Legislative Reception. If you have any questions about the event or need more information about registering, 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. The fastest way to register is to complete this form and click the submit button at the bottom to email it to NCCBI.

Click this link for a quick look at the agenda.

Legislative Conference Registration Form

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 @ $35 each
Number of reception-only non-member attendees @ $45 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