NCSAB Conference Registration

National Council of State Agencies for the Blind

Conference Registration Form
2010 NCSAB Fall Conference

November 10 - 12, 2010
Sheraton San Diego Hotel & Marina
1380 Harbor Island Drive
San Diego, CA 92101

Phone #: 619-291-2900
Toll Free #: 877-734-2726

Complete form to register

Contact Information

* Denotes required field
Name:*
BadgeName:*
Title:
Agency:
Address 1:*
Address 2:
City:*
State:*
Zip Code:*
Phone:*
Fax:
Email:

Accommodations

WHEELCHAIR ACCESSIBILITY
INTERPRETER SERVICES
BRAILLE AGENDA
LARGE PRINT AGENDA
DISC
ASSISTIVE LISTENING DEVICE
Other (Please Explain):

NOTE: A COMPLIMENTARY AIRPORT SHUTTLE IS AVAILABLE FROM THE SAN DIEGO INTERNATIONAL AIRPORT AT THE CURB SIDE MARKED COURTESY VEHICLE. IT RUNS EVERY 25-30 MINUTES BETWEEN THE HOURS OF 5:30 AM. AND 12:00 AM. OUTSIDE OF THESE HOURS GUEST MAY REQUEST A PICK UP BY PHONING THE HOTEL DIRECTLY AT 619-291-2900.

THE SHUTTLE VANS ARE GREY, BLUE AND WHITE. ACCESSIBLE TRANSPORTATION IS ALSO AVAILABLE THROUGH THE HOTEL. PLEASE CALL THE HOTEL DIRECTLY TO REQUEST THIS SERVICE. TAXI SERVICE IS AVAILABLE FOR 6 USD.

RESERVATIONS REQUIRED FOR THE FOLLOWING EVENTS:

Sessions

WEDNESDAY, EXECUTIVE COMMITTEE LUNCHEON – FEE $35.00 PER PERSON
THURSDAY, DIRECTOR’S LUNCHEON - FEE $35.00 PER PERSON
PLEASE NOTE: LUNCHEON IS FOR DIRECTOR AND/OR ONE SENIOR DESIGNEE
FRIDAY, EXECUTIVE COMMITTEE BREAKFAST – FEE $35.00 PER PERSON
I WILL ATTEND THE MEETING ON WEDNESDAY ONLY AND WISH TO PAY THE ONE
DAY REGISTRATION FEE OF $145.00 - EARLY REGISTRATION OR $195 - REGULAR REGISTRATION

NCSAB FED.ID #: 23-7213574

Select Payment Method

Conference Attendance

Please select whether or you are an NCSAB member and if you will attend full conference or only one day.

Validation

You must enter NCSAB in the text box below. This is to ensure a "real" person is completing this form.

Enter the following text: NCSAB*

**ALL REGISTRATIONS MUST BE SECURED BY PURCHASE ORDER OR A CHECK PRIOR TO THE CONFERENCE**

PLEASE RETURN THE COMPLETED FORM TO NCSAB
BY OCTOBER 8, 2010

NCSAB 2010 FALL TRAINING CONFERENCE
4600 VALLEY ROAD, SUITE 100, LINCOLN, NE 68510-4844

FAX: 402-471-3009 E-MAIL: Pearl.vanzandt@nebraska.gov

REGISTRATION FEES AND DEADLINE INFORMATION

THERE IS NO “ON-SITE” REGISTRATION
EARLY REGISTRATION: THROUGH OCTOBER 8, 2010

NCSAB MEMBERS & STAFF: $320.00
NON-MEMBERS: $370.00
ONE DAY REGISTRATION (WED ONLY) $170.00

REGULAR REGISTRATION: OCT. 9 THRU NOV 6, 2010

NCSAB MEMBERS & STAFF: $370.00
NON-MEMBERS: $420.00
ONE DAY REGISTRATION (WED ONLY) $220.00

FEDERAL IDENTIFICATION NUMBER – 23-7213574

LOGISTICS

WHEN: WEDNESDAY, NOV. 10, 2010 TO FRIDAY, NOV.12, 2010
WHERE: SHERATON SAN DIEGO HOTEL & MARINA
1380 HARBOR ISLAND DRIVE
SAN DIEGO, CA 92101
TELEPHONE: 619-291-2900
TOLL FREE : 877-734-2726
FAX : 619-692-2337

CONFERENCE HOTEL RATES: $ 209.00 SINGLE
$ 209.00 DOUBLE
$ 229 DELUXE SINGLE OR DOUBLE
ADDITONAL PERSONS $20.00
PLUS 10.565% STATE/LOCAL TAX (SUBJECT TO CHANGE)

HOTEL RESERVATIONS:

HOTEL RESERVATIONS IN OUR ROOM BLOCK WILL BE SOLD AT THE CONFERENCE RATE THROUGH FRIDAY, OCTOBER 08 OR WHEN THE ROOM BLOCK IS SOLD OUT, WHICHEVER COMES FIRST. RESERVATIONS RECEIVED AFTER 5:00 PM LOCAL TIME ON THE CUT OFF DATE OR AFTER THE BLOCK IS FULL WILL BE ACCEPTED ON A SPACE AVAILABLE BASIS AT THE HOTEL’S PREVAILING RATE.

WHEN MAKING RESERVATIONS OVER THE PHONE, PLEASE ASK FOR THE “CSAVR ROOM BLOCK”

IMPORTANT NOTICE: ALL HOTEL RESERVATION CANCELLATIONS FOR THE CSAVR/NCSAB ROOM BLOCK SHOULD BE MADE THROUGH RITA MARTIN AT 240-632-0709 OR 240-593-2899 OR E-MAIL rmartin@rehabnetwork.org

TO REGISTER - PLEASE RETURN THE COMPLETED FORM TO THE NCSAB VIA MAIL, FAX OR E-MAIL TO:

Pearl.vanzandt@nebraska.gov

NCSAB CONFERENCE REGISTRATION
4600 VALLEY ROAD, SUITE 100, LINCOLN, NE 68510-4844
TELEPHONE 402.471.8100 - FAX 402-471-3009