***Please print-out this form. Fill it out and Fax it to NMSBA at (505) 983-2450.****
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New Mexico School Boards Association
Annual Convention
December 3-4, 2010
at the Radisson Hotel, 2500 Carlisle Blvd, NE Albuquerque, NM
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BILLING ADDRESS:
School District: ________________________________________________________________________
Address: _____________________________________________________________________________
City: ________________________________________________Zip: ____________________________
Submitted By: _________________________________________________________________________
Title: ________________________________________________ Phone: _________________________
Date: __________________________________
ATTENDEES NAMES:
1) Name: ________________________________________ Title: ____________________________________________
*Friday Lunch is optional and is an additional $*TBD*: _____ Attending or _____ Not Attending
2) Name: ________________________________________ Title: ____________________________________________
*Friday Lunch is optional and is an additional $*TBD*: _____ Attending or _____ Not Attending
3) Name: ________________________________________ Title: ____________________________________________
*Friday Lunch is optional and is an additional $*TBD*: _____ Attending or _____ Not Attending
4) Name: ________________________________________ Title: ____________________________________________
*Friday Lunch is optional and is an additional $*TBD*: _____ Attending or _____ Not Attending
5) Name: ________________________________________ Title: ____________________________________________
*Friday Lunch is optional and is an additional $*TBD*: _____ Attending or _____ Not Attending
6) Name: ________________________________________ Title: ____________________________________________
*Friday Lunch is optional and is an additional $*TBD*: _____ Attending or _____ Not Attending
7) Name: ________________________________________ Title: ____________________________________________
*Friday Lunch is optional and is an additional $*TBD*: _____ Attending or _____ Not Attending
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FEES:
Included in the registration - Continental breakfasts on Friday & Saturday.
*Friday Lunch is optional and costs an additional $*TBD*.
Association Members: $100 per person. $125 per person after _____ 2010. A purchase order is considered payment.
Purchase Order # ___________________________________ (Attach a copy of the P.O.)
Non-Members: $400 per person. Payment must be made in advance.
CANCELLATION & REFUNDS POLICY:
100% refund if registration is cancelled in WRITING by _______, 2010.
50% refund if registration is cancelled in WRITING by _____, 2010.
NO SHOWS WILL BE BILLED IF NOT CANCELLED BY DATES SHOWN ABOVE.
Substitutions will be allowed until _____ with no charge. From _____ until _____ a $25 charge will apply. After _____, no substitutions.
HOTEL RATES at the Radisson Hotel are $80 Single/Double, plus tax. Please make your own room reservations by calling 1-505-888-3311. To ensure these rates, please make room reservations as soon as possible and identify yourself as being with NMSBA. Reservation are not guaranteed in this hotel. Purchase order number is required at time of reservation. Rooms are reserved on a first come-first reserved basis.
Fax registration for the conference to NMSBA at (505) 983-2450.
Updated 7/13/10