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00 each at the convention. Please make check payable to NFBF and mail it with completed form s to Gloria Mills Hicks Treasurer National Federation of the Blind of Florida 3708 West Bay to Bay Blvd. NATIONAL FEDERATION OF THE BLIND OF FLORIDA 2016 STATE CONVENTION January 15 18 2016 REGISTRATION FORM Please list everyone who will be attending the convention so your nametag will be ready upon arrival* Please use a separate form for each person* Feel free to print or photocopy additional copies. PLEASE PRINT NEATLY Name Address City Zip Phone Email Are you a member of the NFB Yes No If so what Chapter Complete Pre-Registration includes Banquet Registration 50. 00 Number of people registering Total amount enclosed Banquet Entree Choices number of each Fish Chicken Vegetarian Pasta If you do not plan to attend the Banquet Sunday Night the pre-registration fee for the convention will be 15. 00. If you do not pre-register the fee will be 20. 00 at the Convention* Banquet tickets if available will be 40. Tampa FL 33629 Or you can register and pay for your Registration and Banquet by Credit or Debit Card MasterCard or Visa by calling 1-866-342-5080. NATIONAL FEDERATION OF THE BLIND OF FLORIDA 2016 STATE CONVENTION January 15 18 2016 REGISTRATION FORM Please list everyone who will be attending the convention so your nametag will be ready upon arrival* Please use a separate form for each person* Feel free to print or photocopy additional copies. PLEASE PRINT NEATLY Name Address City Zip Phone Email Are you a member of the NFB Yes No If so what Chapter Complete Pre-Registration includes Banquet Registration 50. PLEASE PRINT NEATLY Name Address City Zip Phone Email Are you a member of the NFB Yes No If so what Chapter Complete Pre-Registration includes Banquet Registration 50. 00 Number of people registering Total amount enclosed Banquet Entree Choices number of each Fish Chicken Vegetarian Pasta If you do not plan to attend the Banquet Sunday Night the pre-registration fee for the convention will be 15. 00 Number of people registering Total amount enclosed Banquet Entree Choices number of each Fish Chicken Vegetarian Pasta If you do not plan to attend the Banquet Sunday Night the pre-registration fee for the convention will be 15. 00. If you do not pre-register the fee will be 20. 00 at the Convention* Banquet tickets if available will be 40. NATIONAL FEDERATION OF THE BLIND OF FLORIDA 2016 STATE CONVENTION January 15 18 2016 REGISTRATION FORM Please list everyone who will be attending the convention so your nametag will be ready upon arrival* Please use a separate form for each person* Feel free to print or photocopy additional copies. PLEASE PRINT NEATLY Name Address City Zip Phone Email Are you a member of the NFB Yes No If so what Chapter Complete Pre-Registration includes Banquet Registration 50. 00 Number of people registering Total amount enclosed Banquet Entree Choices number of each Fish Chicken Vegetarian Pasta If you do not plan to attend the Banquet Sunday Night the pre-registration fee for the convention will be 15.