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National Association of Farm Broadcasting
Washington Watch 2013
Registration Form
May 13-15, 2013
Washington, D.C.
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| ***Please complete the registration form using your COMPLETE LEGAL NAME and SOCIAL SECURITY NUMBER for security purposes!*** |
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First Name: |
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Middle Initial/Name: |
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Last Name: |
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Nick Name: (for name badge) |
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Company: |
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Type: (check one) |
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Address: |
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City: |
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State: |
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Zip: |
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Phone: |
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Fax: |
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Email: |
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Interested in sharing a room?: |
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| Social Security Number*: |
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*if you prefer, please call the NAFB office, 816.431.4032 to provide this information
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Registration Fee: |
(Per Member or Spouse - Signup each separately)
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***You are responsible for your own hotel reservations:***
Holiday Inn Capitol
550 C Street, W
Washington, D.C. 20024
ph: (202) 479-4000
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