Fapt Summer Conference Member Registration Form

FAPT SUMMER CONFERENCE MEMBER REGISTRATION FORM

The Naples Beach Hotel & Golf Club

July 5 – July 9, 2009

NAME: ______

TITLE: ______

DISTRICT: ______ADDRESS: ______

CITY: ______STATE:____ZIP:______

PHONE: ______FAX:______

EMAIL (required): ______

Conference registration fee: $175.00 per member

Retiree registration fee: $25.00 per member

Please complete a separate registration form for each person who will be attending the conference. All persons (other than outside presenters, spouses/guest, and family members) who will be attending all or part of the conference are required to pay the registration fee of $175.00 even if they are not staying at the conference hotel.

If you are bringing a spouse/guest with you to the conference, please complete and send the Guest Registration form that is enclosed with this packet. Prices for meal and function tickets are indicated on the form.

Each delegate registering for the conference will receive one ticket for all events and one additional guest ticket (if requested) for the Monday and Tuesday Member/Vendor Reception and the Wednesday Banquet.

If you are bringing a spouse/guest or children, please list their name(s) below:

Spouse/Guest: ______

Children: ______

______

Please be sure to complete the Spouse/Guest registration form which is enclosed with this packet.

Conference registration fee:$175.00 per member

Retiree registration fee:$25.00 per member

MAKE CHECKS PAYABLE TO: FAPT

*indicate form of payment below*

Company CheckCK#______

District CheckCK#______

Purchase OrderCK#______

Personal CheckCK#______

Pay on Site (Cash or Check)

**In order to properly account for all payments, please mark your check or PO, “Sum Conf 09”, to reference this event only.

Please do not combine payments onto one check for any other training or meeting events of the year – this is exclusively for the “Summer Conference” Naples event only.

Registration form and payment should be completed and sent by US mail, FAX or E-mail to:

Shirley Higgins

Executive Director, FAPT

PO Box 8170

Sebring, FL. 33872

Fax (863) 385-5533

.

Participants who register electronically or provide an E-mail address with their registration will receive an e-mail confirmation notice. All others will receive a fax confirmation. **Deadline for The Naples Beach Hotel and Golf Club, room reservations at the guaranteed rate is June 5, 2009.