2010 Convention

National Association of Farm Broadcasting
2010 Annual Convention Registration Form
November 10,11,12
Westin Crown Center
Kansas City, Missouri

Note: Do not use this form if you are needing to register to exhibit at Trade Talk. Please contact Jennifer Saylor at jennifer@nafb.com.

First Name:

Last Name:

Nick Name: (if any)

Company:

Type: (select one)

StationNetworkCompany

Address:

City:

State:

Zip:

Phone:

Fax:

Email:

Member Status (select one):

Broadcast CouncilManagement & Sales CouncilAllied Industry CouncilHonorary
EmeritusStudentNon-CommercialNon-Member

REGISTRATION FEES: Please note rate changes after OCTOBER 1st. All meals are included with full registration paid. Below list all family members individually. Business associates do not qualify for family rate.

	Check the appropriate box to fill in the rate.		Conv. Rate	After Oct. 1
		BROADCAST COUNCIL, NON-COMMERCIAL,HONORARY, EMERITUS, LIFETIME, STUDENT MEMBER	$200	$225
		MANAGEMENT & SALES COUNCIL MEMBER	$200	$225
		ALLIED INDUSTRY COUNCIL MEMBER	$275	$300
		NON-MEMBER	$400	$425
		ONE DAY MEMBER REGISTRATION DAY: (WED, THUR, FRI)	$175	$200
		ONE DAY NON-MEMBER REGISTRATION DAY: (WED, THUR, FRI)	$225	$250
		FAMILY OF BROADCAST COUNCIL, NON-COMMERCIAL, MANAGEMENT COUNCIL, HONORARY, EMERITUS, LIFETIME, OR STUDENT (each)	$200	$225
		FAMILY OF ALLIED INDUSTRY COUNCIL MEMBER OR NON-MEMBER (each)	$275	$300
				Total:

Others Attending:
(Spouse/Family Member Name)