Registration Form

Scioto Valley Chapter
NCS Spring Meeting
April 17 - 19, 2015
Embassy Suites Columbus - Dublin
5100 Upper Metro Place, Dublin, Ohio
614.790.9000
800.EMBASSY
Registration Form
Name(s):______________________________________________Guest:__________________________________________
Email: ______________________________________________________________________________________________
Address (street, city, state):______________________________________________________________Zip: _____________
Phone: _________________________ Cell: _________________________Chapter: ________________________________
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First-time attendee: _______
Student Pilot Member: ________
AE Scholarship recipient: ______ Year: ________
Current Office(s) / Committee(s):
Past Office(s) / Committee(s):
Chapter: ____________________________________
Chapter: _______________________________________
Section: ____________________________________
Section: _______________________________________
International: ________________________________
International: ___________________________________
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REGISTRATION:
Price
Quantity
Total
* Full registration (postmarked by March 25)
* Late registration (postmarked after March 25)
Fly Market Table (for chapter)
Fly Market Table (other guests)
$109
$120
$10
$30
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A la Carte options: (only if you don’t want full registration)
Friday night, hospitality, fly market
$19
Saturday Columbus Zoo trip and lunch
$45
Hotel Reception and Saturday Banquet
$45
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TOTAL: ________
Banquet requests (include # in your party): ________ - vegetarian ____________________________ - special dietary needs
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PAYMENT: Checks payable to – Scioto Valley 99s Mail to – Janie McIntire, 71 Greenhedge Circle, Delaware, OH 43015
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HOTEL: Embassy Suites Columbus - Dublin. Self-parking. Call hotel to reserve room by March 27.
Mention 99s to receive special rate ($149 per night).
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FLY IN: Commercial: Port Columbus (CMH) ETA __________ Flight # __________ Airline _____________________
Private: The Ohio State Univ (KOSU) Day ___________ ETA __________ N# __________ # passengers _____
QUESTIONS: Janie McIntire – [email protected] – 740.362.7228
OR Paula Rumbaugh – [email protected] – 614.946.2027