NAPIA - Online Registration

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2013 NAPIA ANNUAL MEETING

Westin La Cantera Hill Country Resort
San Antonio, TX
June 19-22, 2013

EVENT REGISTRATION FORM

National Association of Public Insurance Adjusters
21165 Whitfield Place, #105
Potomac Falls, VA 20165
(703) 433-9217
FAX: (703) 433-0369

Please register the following:


             Name: 
        Firm name: 
 Business Address: 
             City: 
            State: 
              Zip: 
   Business Phone: 

       Fax Number: 
           E-mail: 

Is this your first NAPIA meeting:   Yes  No

      Credit Card #: 
Expire Date & CVC #: 
        Credit Card: 
       Name on Card: 

Please print my name badge(s) as shown below:

             Name: 
 Spouse / Guest 1: 
          Guest 2: 
          Guest 3: 
          Company: 
             City: 
            State:

REGISTRATION

Attendee	By May 27th	Ater May 27th
NAPIA Member	$1,215	$1,255
Spouse / Guest	$795	$830
Child (12 & Under)	$275	$295
Non-Members (seminars only)	$595	$650

Golf Registration

Please register the following for the NAPIA Golf Tournament on the Palmer Course at the Westin La Cantera Hill Country Resort on Thursday, June 20 at 12:30 pm:

Golf Tournament - (includes tournament fees, greens fee, cart rental, lunch, refreshments & prizes.) - $125
# of people: Names:

CANCELLATION POLICY

A full (100%) refund of all event registration fees will be applied to cancellations received up to two weeks prior to the first day of the event. A fifty percent (50%) refund will be issued for notices received between one and two weeks prior to the opening day. No refunds will be issued for cancellations received within a week of the opening day.

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