CONVENTION REGISTRATION FORM

Please complete form (print or type), make your check payable to NCS and mail both to:

Richard Heeseler, 2146 Brookside Ave., Wantagh, NY, 11793-3850.
Phone 516-826-1267; email:  convention.registration@mums.org. 
Convention registration must be postmarked by 09/30/2008 to avoid late fee.

Name(s) ___________________________________________________________________________
Phone ______________________________    Email _______________________________________
Address ___________________________________________________________________________
City _________________________________   State ___________        Zip ____________________
Name(s) for Badge(s) ______________________________ /_________________________________
Chapter Affiliation(s) ______________________________
NCS Officials (please circle) Officer   Director   Committee Chair   Local Officer    Other __________
FUNCTION AND FEES (shown per person)	COST	NUMBER	AMOUNT
Registration per person – Postmarked by 9/30/08	$40.00	________	___________
Late Registration per person – Postmarked after 9/30/08	$50.00	________	___________
Awards Banquet – Saturday – 10/18/08	$50.00	________	___________
	TOTAL		___________

AWARDS BANQUET – Please indicate the number of each:

Prime Rib ____________

Chicken Chesapeake ________ (Breast of chicken with lobster sauce and lump crab meat – a regional selection.)

Mushroom Neopolian ___________ (Squash, zucchini, and red peppers marinated and grilled with sliced brie nestled between 2 Portobello mushrooms and served on a bed of fire roasted tomatoes.)

SPECIAL NEEDS:

Food Allergies __________________

Other _________________________

I/We plan to bring (Please include approximate #) Cut Blooms____Pots____Hanging_____Other______

I/We plan to enter Division II Design______________________________________________________

I/We volunteer for Aide/Clerk/Classification/Registration/Tours_________________________________

I/We volunteer to help with______________________________________________________________

DISCLAIMER: The National Chrysanthemum Society, Inc. USA; the Chesapeake Chrysanthemum Society; and the Holiday Inn BWI will not be responsible for the safety of persons or personal property, although all reasonable care will be taken for the protection of both.