Braille Monitor March 2006
2006 National Convention Preregistration Form
Please use this form or provide all the requested information.
Registrant Name ___________________________________________________
(print legibly)
Address _________________________________________________________
City ____________________________________________________________
State ___________________________________ Zip ____________________
Phone __________________________________________________________
___ I will pick up my registration packet at convention.
___ The following person will pick up my registration packet: Pickup Name ______________________________________
Please register only one person per registration form.
One check or money order may cover multiple registrations.
Check or money order (sorry, no credit cards) must be enclosed with registration
form(s).
Number of registrations x $15 = ____________
Banquet tickets x $35 = ____________
Total ______________
Mail to: National Federation of the Blind
Attn: Convention Registration
1800 Johnson Street
Baltimore, MD 21230
Registrations must be postmarked by May 31, 2006.