BANK DEPOSITORY USER GROUP

Hyatt Regency Clearwater Beach Resort and Spa

301 S Gulfview Boulevard, Clearwater Beach, Florida 33767

September 24-27, 2017

REGISTRATION FORM

DEADLINE FOR BDUG REGISTRATION IS SEPTEMBER 1, 2017.

Note: Please complete one form for each attendee from your organization (please ensure handwriting is legible).

NAME TO APPEAR ON BADGE:

TITLE:

BANK/ORGANIZATION NAME:

AREA OF RESPONSIBILITY:

ADDRESS:

CITY/STATE/ZIP:

TELEPHONE NUMBER:

EMAIL ADDRESS:

AMOUNT ENCLOSED:

Please indicate (X) if applicable: First Time Attendee ______Special Dietary Needs:______

Bringing a Guest - Guest’s Name:______

REGISTRATION FEES:

Member Banks:

Early bird registration through 9/01/17: First Bank Attendee included in Membership Fee, Second bank attendee; $450 per attendee. $225 for each member bank attendee after two.

After 9/01/17: First Bank Attendee included in Membership Fee, Second bank attendee $500. $250 for each member bank attendee after two.

Non-Member Banks: $800 per attendee (if registered by 9/1/17); $900 (registered AFTER 9/1/17)

Other Industry Participants: $600 per attendee (registered by 9/1/17); $700 (registered AFTER 9/1/17)

Guests: $250 per guest (includes sponsored meals and receptions)

NOTE: No refunds will be made for cancellations after the BDUG registration refund deadline of August 26, 2016. All cancellation requests are subject to a $75.00 processing fee. Cancellations prior to the refund deadline must be in writing. Please fax your cancellation request to Cindy Lawrence or via email to:

If paying by check, it should be made payable to “BDUG” for registration fees and should be sent along with this form to:

Richard Foster, Membership

Bank Depository User GroupIf paying by credit card:

Citi Bank

3800 Citigroup Center B2/8fax (813) 604-1274

Tampa, FL 33610email:

(813) 604-1676

If paying by credit card, fill out the following information and sign on the signature line. We will not be able to process without a signature.

Type of Credit Card: Master ______Visa ______Amex ______

Name, exactly as printed on the card:______

Account Number:______Business Account Yes ______No ______

Expiration Date:______

Signature:______

PLEASE DO NOT SEND HOTEL REGISTRATIONS WITH THIS FORM.

HOTEL RESERVATIONS MUST BE MADE DIRECTLY WITH THE HYATT REGENCYCLEARWATER BEACH BY CALLING727-373-1234OR CLICKING ON THE FOLLOWING LINK

RESERVATIONS MUST BE MADE BY 9/01/2017TO SECURE THE BDUG RATE OF $215/NIGHT ($205 plus $10 resort fee)

THE PREFERRED ROOM RATE IS AVAILABLE ON A FIRST-COME, FIRST-SERVEDBASIS.