NC National Guard Association & NCNG Combined Event Registration Embassy Suites, 5400 John Q Hammonds Drive, Concord, NC 12-14 MARCH 2015
*Required *Rank *Registrant’s Name _____________________________________ __________
*Association *First Member Convention Yes No Yes No
*Spouse/Guest Name ___________________________________ __________
Yes No
*Address ________________________________________________________
Yes No
*Unit:
*City_______________________________ *State________ *Zip____________ _____________________ *Telephone ____________________________*E-mail___________________________________________
COMBINED EVENT REGISTRATION FEES *FREE PARKING* Retirees & Spouse/Guest (based on rank at retirement)
By 31 JAN Per person
*After 1 FEB Per person
E1-E4 & Spouse/Guest
$25
$35
E5-E7/WO1-CW2/ O1-O2 & Spouse/Guest
$35
$45
All other ranks & Spouse/Guest
$45
$55
Non-Military
$40
$50
Child(ren)
$25
$35
(meal only)
TOTAL **We are unable to accept registration(s) AFTER 27 FEBRUARY 2015
*Saturday Dinner Choices Attendee: Beef
Total
$
Spouse/Guest: Beef
Chicken Chicken Vegetarian Vegetarian Not attending Not attending dinner
dinner
*Attending Business Session: Member: Friday Yes No Saturday Yes No $
No Refunds After 27 Februray 2015
*Attending Friday Evening Event: Member: Yes No Spouse/Guest: Yes No
Register online at https://ncng.meetingservicesinc.com or you can mail the completed form with credit card information or check/money order to: NCNGA; ATTN: Katie Westbrooks, 7410 Chapel Hill Rd.; Raleigh, NC 27607. Checks should be made payable to NCNGA. (There is a $2 processing fee for credit/debit card charges.)
Your seating assignment will be with your home unit. Any special seating arrangements will need to be addressed with your MSC Rep no later than 21 February 2015. _____ Joint Force Headquarters
_____ 449th Theater Aviation Brigade
_____ NC Air National Guard
_____ 113th Sustainment Brigade
_____ 60th Troop Command
_____ 139th Regiment (Combat Arms)
_____ 130th MEB
_____ Associate/Retiree
_____ 30th Armored Bde Combat Team
_____ NCNGA (Staff ,EF,Aux,MHS,Volunteer)
Method of Payment: ____Check enclosed ____Charge my: ____MasterCard ____Visa **There will be a $23 returned check fee on returned items **There is a $2 processing charge for credit cards Account #________________________________ Expiration date ____________3 digit security code ______ Authorized Signature ____________________________________________________________________
Page 6 – Tarheel Guardsman — December 2014/January 2015