Future Reflections          Winter/Spring 2008

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2008 Seminar Registration

Mail to: Sandy Taboada, NOPBC Registration 6960 South Fieldgate Court Baton Rouge, LA 70808-5455

NOPBC Conference Fees

NOPBC Fees, including dinner tickets to the Sunday night, June 29, anniversary buffet: $25 per adult, $15 per youth (ages 12 and up), and $7 per child (ages 6-11), ages 5 and under, free. Tickets for the buffet dinner may not be available at registration, so PLEASE register early.

NOPBC Fees, no dinner tickets: $20 per adult, no charge for children and youth accompanied by family members. Teens accompanied by chaperones, $15 per teen.

Fee enclosed (make checks payable to NOPBC) $________________

Make checks or money orders payable to NOPBC.

You can either register for specific workshops online at <www.nfb.org/nopb>, or request a hardcopy registration form.
Please check your choice: [ ] online [ ] send hardcopy

Adult Name(s). Please include first and last names of each adult and please check relationship or interest in the NOPBC:
1. _______________________________________________________________________
[] parent [] relative [] professional [] blind parent [] chaperone for teens [] other
2. ____________________________________________________________________________
[] parent [] relative [] professional [] blind parent [] chaperone for teens [] other

Address ______________________________________________________________________

City __________________________ State________________________ Zip________________

Telephone(s) ____________________________ E-mail _____________________________

Do you already receive Future Reflections? [] YES [] NO
Are you a member of your state POBC chapter? [] YES [] NO
Is this your first NFB Convention? [] YES [] NO

Please list names (first and last), birth dates, and grades of all children attending the convention with you. Please include a brief description of the child�s vision and any additional disabilities.

Name                                                       Birth Date  Grade     Vision/other

1. ______________________________ ________ ____ _________________

2. ______________________________ ________ ____ _________________

3. ______________________________ ________ ____ _________________

4. ______________________________ ________ ____ _________________

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