2024 NAPSEC Annual Leadership Conference Registration Form

2024 NAPSEC Annual Leadership Conference

REGISTRATION FORM

January 14-17, 2024

The Westin
Savannah, GA
Name*

FirstMiddleLast
Email for confirmation and conference news*
Agency/Program
Phone number*

Area CodePhone Number
Are you a first time attendee?*

YesNo
Would you like a mentor during the conference?

YesNo
Please indicate any food allergies or dietary restrictions*
Please indicate any ADA accommodations needed to participate in this conference
Conference Photo Release Acceptance*

NAPSEC will take photos of attendees throughout the conference. These photos are for NAPSEC use only and may appear on the NAPSEC website, newsletter, conference brochures, social media outlets, or other future NAPSEC promotional material. By virtue of your attendance, you agree to usage of your likeness in such media.
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Mail Check

Please complete and submit your online registration below, and send payment to: NAPSEC/Danielle Damm 1200 First Street NE, FRNT 200 Washington, DC 20002
NAPSEC Annual Leadership Conference Registration

NAPSEC Member Registration - $800Additional Attendee from NAPSEC Member Program - $650 (bring your program colleagues and get a discount!)First time conference attendee - $625Non-Member Registration - $950Raffle Voluntary Contribution - $100 Please add a voluntary contribution of $100 to my registration fee to support the NAPSEC Foundation and the NAPSEC AwardeesRich Robinson Memorial Golf Classic - $100 (1 Golfer) - (indicate golfer's name below) - Wednesday, January 17th (green fees, lunch, and (2) alcoholic beverages included).Rich Robinson Memorial Golf Classic - $200 (2 Golfers) - (indicate golfer's name below) - Wednesday, January 17th (green fees, lunch, and (2) alcoholic beverages included).Full Guest Registration Fee - $350 (indicate guest's name below) - Guest options are only for family and/or friends who come to the conference with an attendee. The Full Guest Fee includes (3) breakfasts, (3) breaks and a conference program and participation in the Welcome Reception, NAPSEC Happy Hour & Exhibitor Showcase, and the Awards Luncheon.Guest Fee - $75.00 - (indicate guest's name below) – Welcome Reception (Sunday evening)Guest Fee - $60.00 - (indicate guest's name below) – NAPSEC Happy Hour & Exhibitor Showcase (Monday evening)Guest Fee - $75.00 - (indicate guest's name below) – Awards Luncheon (Tuesday)
Total
REGISTRATION FEES

NAPSEC Annual Leadership Conference Registration

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Rich Robinson Memorial Golf Classic
Golfer (1) Name

First NameLast Name
Golfer (1) handicap/average shot/18 holes
Golfer (1) Renting Clubs

YesNo
Golfer (2) Name

First NameLast Name
Golfer (2) handicap/average shot/18 holes
Golfer (2) Renting Clubs

YesNo
GUEST REGISTRATION
Guest Name
Please indicate any food allergies or dietary restrictions
Selections:

Full Guest Fee $350Welcome Reception - January 14th $75NAPSEC Happy Hour & Exhibitor Showcase - January 15th $60Awards Luncheon - January 16th $75
THANK YOU FOR YOUR REGISTRATION!

Cancellations received before December 13, 2023 will be refunded in full less a $25 handling fee. No refunds will be given after December 13, 2023.

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