If this is a double registration (NAIFA Member/Spouse or Member/Guest) ___ Yes ___ No
_______________________________________________________ ____________________________________________________ Spouse or Guest Name Nickname for Badge
~~Guest Registration: Fee required if guest is 17 or older. Anyone in the insurance business is required to pay the full
Name Tags for children ________________________________________ age __________
_____________________________________________- age _________, ______________________________ age _____________
We must have an accurate count for the noon Monday Awards Banquet, Pizza Party and
Tuesday's Breakfast. PLEASE CONFIRM ATTENDANCE:
/__/ Yes, # of attendees for Banquet _____ /__/ Kids Pizza Lunch _____ /__/ Tuesday Breakfast _____
2014 CONVENTION REGISTRATION FEES
Registration and Payment Policy: Please send payment with registration form. Registration will not be processed until payment is received.
Cancellation Policy: All cancellations must be in writing to the NAIFA-MS office. Cancellations after
May 27th, will be charged a processing fee of $75.00.
Fees include – Opening Night Event, Meetings, Banquet & Tuesday breadfast (Golf Tournament is separate)
• Double Registration includes admission for two to above functions. (NAIFA Member/Spouse or
Member/Guest) • Single Registration includes admission for one to above functions.