139th NGAUS General Conference & Exhibition

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139th NGAUS General Conference & Exhibition | September 7-10 Louisville, KY NGAUS State Attendee Conference Registration Form MEMBER REGISTRATION Check any if applicable: ___ Retiree ___ Current TAG ___ Former TAG ___ I would like to be considered as a delegate for my state Full Name _____________________________________________________________ Name on Badge _____________________________ (Include Rank/Title/Prefix/Suffix if applicable)

Address ________________________________________________________City ____________________ State _____ Zip __________ E-mail ____________________________________________________ Phone ____________________________________________ By providing an e-mail address, NGAUS will be able to send to you conference updates, special event invitations, etc.

SPOUSE OR GUEST REGISTRATION Check one if applicable: ___Spouse

___ Guest

Full Name _____________________________________________________________ Name on Badge __________________________ (Include Rank/Title/Prefix/Suffix if applicable)

NGAUS REGISTRATION FEE: NGAUS member and member’s guest pay $225 each and includes SEC Hospitality night tickets and State hospitality room. Refunds, less a $15.00 administration fee, will be granted for requests received in writing prior to 11:59 PM EST August 15, 2017. All refunds will be processed after the conclusion of the conference. After August 15, 2017 all sales are final and no refunds will be processed. CONFERENCE EVENTS Check which of the following events you and/or your guest(s) will attend. NGAUS Golf Tournament September 7 ___Me ___Guest ___Both CG/WO Mixer September 7 ___Me ___Guest ___Both Fun Run September 8 ___Me ___Guest ___Both Spouses Luncheon September 9 ___Me ___Guest ___Both Warrant Officer Luncheon September 9 ___Me ___Guest ___Both Retired/Separated Luncheon September 9 ___Me ___Guest ___Both States Dinner September 10 ___Me ___Guest ___Both

$125/person Included in registration fee $20/person Included in registration fee Included in registration fee $5/person Included in registration fee

ACCOMMODATIONS Our state’s hotel room block is at The Galt House (conference headquarters hotel) A $100 deposit is required to reserve a room. Reservations must be made through the NGAAL office. Check-in Date ____________________ Check-out Date____________________ OR ____ I don’t need a hotel room TRANSPORTATION Arrival Airline: ________________________Flight #_____________Arrival Time: _______________ Departure Airline: ________________________Flight #_____________Departure Time: ____________ METHOD OF PAYMENT - Check or Credit Card Check # _________________________ Make check payable to NGAAL CC Type ___________ CC # ______________________________ CVV __________ CC Expiration Date ________ Zip Code ___________ $____________ $_100.00_____ $____________ $____________

Total Cost for Conference Registration Fees Hotel Deposit Total Cost of Additional Conference Events Total Amount

Please note any special requirements or dietary restrictions:

RETURN THIS FORM WITH PAYMENT TO : NGAAL, c/o Marlene Hawkins, , 8620 Mohring Place, Leeds, AL 35094, or call 205-699-0433.