NATIONAL ASSOCIATION FOR RIGHTS PROTECTION AND ADVOCACY
2006 ANNUAL RIGHTS CONFERENCE
SOCIAL JUSTICE THE TIME IS NOW!
REGISTRATION FORM Type or print legibly. List name and contact information as you want it to appear in the conference packet.Name:________________________________________________________
Organization:
__________________________________________________
Address: ______________________________________________________
Phone: _________________________________________
E-mail:
_________________________________________
Accommodation Request:
Diet ____________________________
Sign Language
Interpreter _________________
Accessible
Accommodations _________________ Service Animals ______________
Other
_____________________________________________________________________________
Please be considerate of chemically sensitive individuals. We ask that you smoke only in designated areas and wear non-perfumed items.
Full registration includes a one-year NARPA membership for non-members; Wednesday Reception, 3 Continental Breakfasts, 2 Lunches, and snack/drink Breaks. Fee does not include room. Make reservations directly with the Tremont Plaza Hotel.
| Late Registration | (After Nov. 10) | $380 | $______ |
| Day Attendees | $45 per day Wednesday & Saturday | ___ | $______ |
| $55 per day (after Nov. 1) | ___ | $______ | |
| $125 per day Thursday & Friday | ___ | $______ | |
(2 meals & all day program) |
|||
| Contribution to Scholarship Fund | (NARPA is a 501(c) 3 tax-deductible org.) |
$______ | |
| Total Enclosed: | $______ |
U.S. MAIL, FAX, AND E MAIL REGISTRATIONS MUST BE RECEIVED BY FRI., NOV. 10, 2006.
CHECK OR MONEY ORDER (U.S. Currency only.)
Make payable to NARPA National Association for Rights Protection and Advocacy, Inc.
CREDIT CARD (Please indicate): MasterCard VISA
Furnish all information: Card#_____________________________Exp. Date________
Cardholder Name _____________________________
Address of Cardholder______________________________________________
_________________________________________________________________
Signature _________________________________________________________
*Include the three-digit security code from the back of credit card:
_________
NOTE: Please fill out a separate registration form for each person registering.
The Tremont Plaza Hotel on St. Paul
The Tremont Plaza Hotel on St. Paul is in the heart of downtown Baltimore, Maryland. It features 360 guest suites, each with a fully equipped kitchenette.
Check www.tremonts.com for more hotel information.
NARPA 2006 Conference Information
NARPA, P.O. Box 40585, Tuscaloosa, AL 35404