National Association of Farm Broadcasting
Washington Watch 2013
Registration Form
May 13-15, 2013
Washington, D.C.

 
***Please complete the registration form using your COMPLETE LEGAL NAME and SOCIAL SECURITY NUMBER for security purposes!***
First Name:  
Middle Initial/Name:
Last Name:  
Nick Name: (for name badge)
Company:
Type: (check one)
Address:
City:
State:
Zip:
Phone:  
Fax:
Email:  
Interested in sharing a room?:
Social Security Number*:  
*if you prefer, please call the NAFB office, 816.431.4032 to provide this information
 
Registration Fee: (Per Member or Spouse - Signup each separately)
 
***You are responsible for your own hotel reservations:***

Holiday Inn Capitol
550 C Street, W
Washington, D.C. 20024
ph: (202) 479-4000