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Executive Committee & Business Board of Advisors Meeting April 8 - 10, 2010 Marriott Wardman Park Hotel 2660 Woodley Road, NW Washington, DC 20008
LEGISLATOR REGISTRATION FORM *** Online Registration open until Thursday, March 25th 2010 ***
First Name:
State:
Phone: (area code)
Room Preference: (Room type is on a request basis and is not guaranteed)
Indicate extra nights:
American Express Master Card Visa Other:
**The hotel requires a credit card number for extra nights to guarantee your reservation**
PLEASE NOTE THAT NHCSL ONLY COVERS MEETING EVENT NIGHTS/ YOUR CREDIT CARD WILL BE CHARGED BY THE MARRIOTT HOTEL FOR ADDITIONAL NIGHTS (ROOM, TAX & INCIDENTALS) UPON CHECK OUT FROM THE HOTEL.
CHECK ALL EVENTS YOU PLAN TO ATTEND.
2:00 pm – 4:00 pm
NHCSL Task Force Meeting
NHCSL Welcome Reception (May be offsite)
10:00 am – 2:00 pm
Obesity Summit (Lunch served)
NHCSL Executive Committee & BBA Meeting (Breakfast served)
ROOM CANCELLATION POLICY: Room reservation cancellations must be made 72 hours prior to arrival date. When I cancel my reservations within 72 hours of arrival I will be required to pay a cancellation fee of one night’s room and tax and the hotel will cancel my entire reservation. If I do not arrive at the hotel on the date indicated on my registration form, I will be considered a “no show”. Hotel changes or cancellations must be submitted in writing to the NHCSL registration office 72 hours in advance of arrival date.
REGISTRATION AGREEMENT: NHCSL is offering Hispanic Legislators a scholarship to attend this meeting. To qualify for the scholarship I understand that I must be a member in good standing (if not please enclose a $100.00 check for annual membership dues). In requesting and accepting NHCSL’s scholarship (includes air, hotel & some meals) I commit to fully participate at NHCSL’s Executive Committee & BBA Meeting to be held on April 8th - 10th, 2010 in Washington, DC. Moreover, if I accept to participate and do not attend the meeting activities, NHCSL will require full reimbursement from my state or myself for all expenses incurred.
This application is a legally binding agreement. Authorized signature is required.
I have read and understand the above terms & conditions
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