522nd Washington State Federation Convention
"FACING THE FUTURE: INVOLVED, INFORMED, CONNECTED"
National Active and Retired Federal Employees
May 15-17, 2011
Mirabeau Park Hotel & Convention Center
1100 N. Sullivan Road
Spokane Valley, WA. 99037
REGISTRATION FORM (PLEASE PRINT ALL INFORMATION)
Please use a separate registration form for each person attending.
Name: ______Chapter/Member No _____/______
(First) (MI) (Last)
Address: ______
City: ______State: ______Zip: ______
Telephone: (_____) ______E-Mail: ______
( ) Delegate-at-Large ( ) Delegate ( ) Member ( ) Visitor (Non-Voting)
Please indicate if this is the first time you are attending a WSFC Convention: ( ) First Timer?
NOTE: The Visitor fee does not provide access to the business sessions or workshops. Individuals wishing to attend business sessions and/or workshops must pay the full registration fee.
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Registration Fee (Before March 31) ...... $25.00 $ ______
Late Registration Fee (Received after March 31) ...... $30.00 $ ______
Visitor Fee ...... $ 5.00 $ ______
Meals (All meal prices include tax & gratuity. Coffee, tea and water will be provided – all other beverages will be at your own expense.)
Monday, May 16, 2011 - Legislative Luncheon ...... $30.00 $ ______
Please indicate lunch choice: [ ] Turkey Sandwich & Soup or [ ] Caesar Salad Soup
Monday Evening Social Event ...... $15.00 $ ______
* Dinner on your own
Tuesday, May 17th . . . . . Breakfast for Chapter Presidents Only ...... No Cost
* Lunch on your own
Tuesday Evening Banquet ...... $45.00 $ ______
Please indicate dinner choice: [ ] Chicken Chardonnay or [ ] Top Sirloin - Hickory Spice
TOTAL AMOUNT ENCLOSED ...... $ ______
NOTE: Should you have special dietary needs for health reasons (Low Salt, Diabetic or Vegetarian), contact: Roger Bosky, 4001 S. Lloyd Rd, Spokane, WA. 99223, 509-443-0686 () before completing the included meal section.
Please complete and mail this Registration Form with check payable to NARFE WSFC Convention 2011, before March 31, 2011, to: Phil Moyle, Convention Treasurer, 2403 W. Ballard Rd, Spokane, WA. 99208-8317
REFUND POLICY: The deadline for refund of Registration is April 15, 2011; Meals is May 01, 2011.
No refunds for cancellations made after the above dates.
ROOM RESERVATIONS: These MUST be made directly with The Mirabeau Park Hotel Reservation Desk at (509-924-9000. The Host Chapter # 32 has negotiated a special rate of $ 85 (single or double), $95 triple and $105 for quad, plus taxes and fees. DEADLINE for obtaining this NARFE rate is April 15, 2011.