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National Association of Activity Professionals Celebrating 31Years 2013 Conference Registration Form—Las Vegas, Nevada Please Type or Print Clearly: Date: ____________________ Name: ______________________________________________________ Credentials: _____________________ Address: _____________________________________________________________________________________ City: _________________________________________ State/International: ____________ Zip: ____________ Phone (H): __________________________ (W): _______________________ (F): __________________________ E-Mail (W): _________________________________________ (H): ____________________________________ NAAP Membership #: _________________ Expiration Date: _________________ New: __________________ Corporation:____________________________________________ (P): __________________________________ Address: ________________________________________ City/State/Zip: _______________________________ Please Note Current Membership will be verified. Any registration received without a check or credit card will be considered invalid and will not be processed until payment is received. NAAP does not accept Purchase Orders. SPECIAL—SPECIAL—SPECIAL—SPECIAL

Early Bird Registration

Pre-Conference Registration

(On or before March 22, 2013) Please note the difference in Registration cost for Staying and Not Staying at the Tropicana Hotel. This MUST be done in order to meet NAAP’s Room block obligations at the Tropicana.

NAAP Member (Staying at the Tropicana) NAAP Member (Not staying at the Tropicana ) Non-Member (Staying at the Tropicana) Non-Member (Not staying at the Tropicana) Speaker Registration (Staying at the Tropicana) Speaker Registration (Not staying at Tropicana) Corporate Rate (Staying at the Tropicana) Corporate Rate (Not staying at Tropicana)

$295.00 USD $395.00 USD

$150.00 USD

(8:30 AM—5:30 PM -– Tuesday, April 23, 2013)

 5 Hours Chair Chi Training

$ 80.00 USD

(1:00 PM—6:30 PM Wednesday April 24, 2013)

 Get Both Pre-Conferences for: ($30.00 Savings)

$199.99 USD

$395.00 USD $495.00 USD $150.00 USD $250.00 USD $275.00 USD

$375.00 USD Important Notice: Any Corporation wishing to use the New Corporate Rate, must follow instructions on page 2. Late Registrations (Postmarked after March 23, 2013)

NAAP Member Non-Member Speaker Registration

 8 Hours Mentor/Consultant Workshop Training

$395.00 USD $495.00 USD

$195.00 USD Please add $100.00 to the LATE registration if you are not staying at the Tropicana

One Day ONLY Registrations (Members or Non-Members) (On or before March 22, 2012) Early Late  Thursday Only $210.00 USD $240.00 USD  Friday Only $225.00 USD $250.00 USD

Day Registration DOES NOT include any MEALS Please Specify the Following:  First Time Conference Attendee  Need Handicap Assistance  State/International Contact

 Theme & Awards Night Dinner (Extra) $99.00 USD

Full Registration Fee INCLUDES This Year ONLY Admission to Education Sessions, Exhibits, Theme &Award Night Dinner, (Pre-Conference Sessions are Not Included) Meals will be served in Hotel Dining Hall DIETARY PREFERENCE:  Vegetarian Meal  Kosher Meal - (Means NO Pork) Credit Card Payment: Visa  Master Card  American Express  Discover Card Total Amount Enclosed: $ ______________ Email: ____________________________________________________________ Name as it appears on card: ___________________________________________ Expiration Date: ____________________ Credit Card Number: _____________________________________________________________________________________ Address to where you receive your Credit Card Statement: ____________________________________________________ ________________________________________________________________________________________________________ Make Checks/Money Orders payable and mail to: Please Note: A $50.00 Fee will be Charged For all RETURNED CHECKS

NAAP—PO Box 277– LaFollette, TN 37766 (P): 423-201-9415 (F): 423-437-8196 Federal ID # 36-3253020

National Association of Activity Professionals PHOTO RELEASE: Please read the photo release below and check the appropriate box: “I give my permission….” I do not give my permission for the National Association of Activity Professionals to publish my name/photo taken at the 2011 Conference in Myrtle Beach, South Carolina in the association’s publications, videos and/or website. I further understand it is my responsibility to make sure I am not in a group photo if I do not want my picture to appear in future publications or on the NAAP website: NOTE: Implied consent is granted if the box IS NOT checked. Please Print Clearly:

Name: ___________________________________________ Date: ______________ Signature: ___________________________________________________

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