2015 NJAD & NJRID Biennial Conference Hilton Hasbrouck Heights 650 Terrace Avenue, Hasbrouck Heights NJ 07604 NJAD & NJRID Registration Form Please check which membership you are with: NJAD NJRID Full name: _________________________________________________________________________ Add Guest/Spouse Full name:_______________________________________________________________ Address:__________________________________________________________________________________ City, State, Zip ______________________________________________________________________ Phone:______________________________________________________ VP Voice Fax Email: _____________________________________________________________________________ CONFERENCE FEES: 1. Registration Fees Info: See the back of this page. POSTMARKED & PAID BEFORE/BY SEPT. 6 SEPT. 7 to NOV. 1 a. Pre-Conference Registration NJAD/NJRID Member NJAD/NJRID Non-member b. Full Combo NJAD/NJRID Member NJAD/NJRID Non-member $180. x ___ $200. x ___ $210. x ___ $230. x ___ c. Two Days Registration NJAD/NJRID Member NJAD/NJRID Non-member $125. x ___ $145. x ___ $155. x ___ $175. x ___ Total: $ _________ Total: $_________ 2. Payment of 2015-16 Membership Dues (membership form attached): NJAD Yes No NJRID Yes No 3. Special Dietary Meals: Gluten Free: You Guest Vegetarian: You Guest Other: ___________ You Guest 4. Special Request Accommodation: Deaf-Blind Low Vision 5. Plan to stay at the Hilton Hotel? CART Yes Assistive No Reserved? Yes No Cancellation/Changes/Refunds: All Registrations are non-refundable & non-transferable. No exceptions! PAYMENT METHOD: Check or Money Order payable to: NJAD-NJRID Conference. There will be a $35.00 fee charged on checks returned by the bank due to insufficient funds. Registration confirmation/receipt will be e-mailed or mail. MAIL TO: NJAD & NJRID Registration, PO Box 250, Estell Manor, NJ 08319-0250 REGISTRATION INFORMATION: Pre-Conference Registration includes the following: ???? Combo Registration includes the following: Friday Social night, Saturday admission to all the workshops & exhibits; Morning/Afternoon Breaks, Awards Luncheon, Celebration Dinner, Entertainment and Sunday Breakfast & workshop. NJAD and NJRID members save up to 60% on registration rates. Two Days Registration includes the following: Friday Social night, Saturday admission to all the workshops exhibits; Morning/Afternoon Breaks, Awards Luncheon, Celebration Dinner & Entertainment.
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