NCTWS Annual Meeting

Leopold's "Back to the Basics"
February 28 - March 1, 2012
Haw River State Park, Browns Summit, NC
Registration Form
Please complete registration by February 1, 2012!

Name - required First Last
Agency/Company
Phone - (###) - ### ####
Email - required
Select Registration, Lodging and Meals
Registration/Lodging/Meals Cabin ($85/day) Tuesday night Cabin ($85/day) Wednesday night Motel - double ($105/day) Tuesday night Motel - double ($105/day) Wednesday night Motel - single ($135/day) Tuesday night Motel - single ($135/day) Wednesday night
Commuter Only - Registration fee Registration - $20
Commuter Only - Select individual meals ($11 each) Tuesday Dinner Wednesday Breakfast Wednesday Lunch Wednesday Dinner Thursday Breakfast Thursday Lunch
Please select if you prefer Vegetarian options Vegetarian Meals
Select if you wish to include 2012 Annual Dues Add $10 for 2012 Annual Dues
Select for late registration (after February 1, 2012) Add $10 for late registration
If you selected motel double occupancy or cabin lodging, please use the spaces below to indicate roommates.
If you selected cabin occupancy, please specify choice of 3 roommates. Note: You must provide your own linens or bring a sleeping bag.
If you selected motel double occupancy, please indicate roommate choice.
Silent Auction - please share description and value of auction item you plan to bring.
Please indicate total amount for charges above. After you hit submit you will be directed to a NCTWS payment page to select your payment options.

After payment is submitted, you will receive an e-mail receipt from NCTWS within 5 days.