ACBNY 2019 Convention Registration

ACBNY 2019 Convention Registration - Paypal

October 25 through 27, 2019
Hampton Inn Suites
25 Chapel Street
Albany, NY, 12210
518-432-7000

Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone number where you can be reached
I am currently a member of ACBNY

I am currently a member of ACBNY Yes No
Please select your format for the convention program

Please select your format for the convention program Braille Large Print Email
I will be staying at the Hampton Inn and Suites at $101 per night:

I will be staying at the Hampton Inn and Suites at $101 per night: Thursday October 24 Friday October 25 Saturday October 26
Name of Roommate(s) if any:
Registration Fee

Registration Fee $20 if before September 16 $25 if after September 16
Would you like to purchase the full meal plan? (If so, please skip individual meal prices below)

Would you like to purchase the full meal plan? (If so, please skip individual meal prices below) $125 if before September 16 $145 if after September 16
I will be joining ACBNY for Friday Lunch

I will be joining ACBNY for Friday Lunch Yes, included in my Meal Plan indicated above $22 if before September 16 $25 if after September 16 I will not be attending Friday Lunch
Lunch Selection (see Convention Menu for details)

Lunch Selection (see Convention Menu for details) Tuna Wrap Turkey Wrap Vegetable Wrap
I will be joining ACBNY on Friday for the Scholarship Dinner and Entertainment.

I will be joining ACBNY on Friday for the Scholarship Dinner and Entertainment. Yes, included in my Meal Plan indicated above $50 if before September 16 $60 if after September 16 $25 for Entertainment Only I will not be attending the Scholarship Dinner and Entertainment
Scholarship Dinner Selection

Scholarship Dinner Selection Vegetable Stir Fry Chicken Piccata
I will be joining ACBNY for Saturday Lunch

I will be joining ACBNY for Saturday Lunch Yes, included in my Meal Plan indicated above $22 if before September 16 $25 if before September 16 I will not be attending Saturday Lunch
Lunch Selection

Lunch Selection Pear Salad Monte Kristo
I will be attending the Banquet

I will be attending the Banquet Yes, included in my Meal Plan indicated above $40 if before September 16 $50 if after September 16 I will not be attending the banquet
Banquet Dinner Selection

Banquet Dinner Selection Hangar Steak Bakmi Goreng (Vegetarian noodle dish)
Would you like to purchase one of the Sponsorship Levels?

Would you like to purchase one of the Sponsorship Levels? Platinum $500 Gold $100 Silver $50 Bronze $25
Would you like to purchase ACBNY Hoodies? Please indicate how many you would like ($30 per shirt)
Please indicate what kind of hoodies you would like.

COLOR OPTIONS: black, red and blue

SIZE OPTIONS: medium, large, 1X, 2X, 3X, 4X
For help or information, please contact Kathy Casey at 518-462-9487, or via email address at kathycasey623@gmail.com
Spam Protection. Please answer this simple question:
5, 6, 7, 8 : the 4th number is?
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Total

ACBNY 2019 Convention Registration - Paypal

ACBNY 2019 Convention Registration - Paypal

For help or information, please contact Kathy Casey at 518-462-9487, or via email address at kathycasey623@gmail.com

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Total

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