ANNUAL CONFERENCE, 2011
"Wilmington at War: A Military Crossroad"
CONFERENCE REGISTRATION
| Name | |
| Institution | |
| Street Address | |
| Address (cont.) | |
| City | |
| State/Province | |
| Zip/Postal Code | |
| Work Phone | |
| Home Phone | |
| FAX | |
Please choose from the following options:
| Full Conference | $105.00 | |
| Full-time Student or Teacher (supporting documentation required) | $65.00 | |
| Thursday Only | $20.00 | |
| Friday Day Program Only | $50.00 | |
| Friday Dinner Only | $30.00 | |
| Saturday Day Program Only | $25.00 |
Please print and complete this application form, and mail it with payment of $________
You may pay with a check or Visa/Mastercard only.
Number: _____________________________________________ 3-digit CVV code: ______
Signature: ____________________________________________ Expiry Date: ___________
North Carolina Maritime History Council 315 Front Street Beaufort NC 28516 USA Copyright © 2011 North Carolina Maritime History Council. All rights reserved.