Regional Conference Registration

Risk Management & Financial Essentials for Nonprofit Leaders

June 11–12, 2009 • The Colony Hotel • Kennebunkport, ME

Fill out and then print out this form, or print out and handwrite in the blanks. Then just fax or mail.

First Registrant
Name
Title
Organization
Street Address
City
State Zip 
Telephone Fax 
E-mail
Vegetarian? Fill in or circle only if Yes
Special Needs or Requests

Second Registrant
Name
Title
E-mail
Vegetarian? Fill in or circle only if Yes
Special Needs or Requests

Third Registrant
Name
Title
E-mail
Vegetarian? Fill in or circle only if Yes
Special Needs or Requests

Fourth Registrant
Name
Title
E-mail
Vegetarian? Fill in or circle only if Yes
Special Needs or Requests

Fifth Registrant
Name
Title
E-mail
Vegetarian? Fill in or circle only if Yes
Special Needs or Requests

Pricing

Members of Maine Association of Nonprofits or New Hampshire Center for Nonprofits:

__ x $195 for first registrant

__ x $170 for each additional registration

Special pricing for small nonprofits whose annual revenues are $500,000 or less)
__ x $150 for each registration

Nonmembers:
__ x $295 for each registrant

__ x $270 for each additional registration

Special pricing for small nonprofits whose annual revenues are $500,000 or less)
__ x $250 for each registration

Billing

__ Check (made payable to Nonprofit Risk Management Center)   __ Credit card

Name on card
Organization
Street Address
City
State Zip 
Telephone
Type __ Visa  __ MasterCard  __ American Express
Number   Expiration