Online Registration for NIBA’s 2010 Annual Convention

Please fill in the information below and press submit to register online – you will then be directed to the paypal payments page to securely process the registration cost, spouse/companion and golf fees as applicable. Remember, after you press submit at the bottom of this page – you still have not paid, that will be on the next screen.

Required *

Full Name*:
First Name as to be printed on badge*:
Company*:
Mailing Address*:
City*:
State/Province*:
Zip*:
Country:
Phone*:
Fax:
E-mail Address*:

If Applicable:

 

Spouse/Companion Full Name:

First Name as to be printed on badge:

Spouse/Companion E-mail Address :

First NIBA Convention?

  
First NIBA Convention Delegate
First NIBA Convention Spouse / Companion

Golf:

 

If golfing, please fill in your handicap

If your spouse/companion is golfing, please enter their handicap
If you need clubs, do you require a left or right handed set

Special Events

9/18, Sat. Evening – Elemental Welcome Reception and Dinner

9/19, Sun. Afternoon – Delegate Activity

9/19, Sun. Afternoon – Spouse/Companion Activity

9/20, Mon. – Tennis Tournament

9/20, Mon. – Golf Outing

Golf Outing Companions

(please list and persons/companies with whom you would like to play)

9/20, Mon. Afternoon – Delegate Activity

9/20, Mon. Afternoon – Spouse/Companion Activity

9/21, Tues. – 3rd Annual NIBA Fun Run / Walk

9/21, Tues. – Farewell Reception

Spouse/Compantion Activities

9/20 Mon. Morning – Spouse/Companion Activity

9/21 Tues. Morning – Spouse/Companion Activity

Fees:

After you press submit at the bottom of this page you will be directed to the next screen where you will add the registration, spouse/companion and golf fees as applicable, then be redirected to paypal’s secure server to process your credit card online.

 

 
 6737 W Washington St, Suite 1300, Milwaukee, WI 53214 • Phone: 414-389-8606 • Fax: 414-276-7704  
 
Convention index NIBA