2010_DC_Attendee_Registration_Form

2010 Development Conference November 3-5, 2010 | Grand Hotel Marriott, Point Clear AL

Credit Union Information - All Fields Are Required Credit Union: ____________________________________________________________________ Address: _______________________________________________________________________

Early B Octobird Deadl in er 1, 2010 e:

City: __________________________________________________________________________ State: _________________ Zip: ___________ Phone: __________________ Extension: ______ Contact Person: __________________________________________________________________ Title: ______________________________ Email Address: _______________________________

Name, Title, & Email

Early Bird Registration for Attendees Deadline: Oct 1, 2010

Conference Registration for Attendees

Conference Registration for Guests

Post: Oct 1, 2010

These events are open to attendees, guests, and exhibitors.

Leadership Council Pre-Conference Workshops

Spouse & Guest Session: Historic Tour & Luncheon

Offsite Sunrise Sailboat Cruise & Breakfast

Total ____

Total ____

Golf Tournament

Governmental Affairs Luncheon

 CFO  IT  HR  LEND  OPS  MKTG

__Attendee __ Guest

 CFO  IT  HR  LEND  OPS  MKTG

__Attendee __ Guest

 CFO  IT  HR  LEND  OPS  MKTG

__Attendee __ Guest

 CFO  IT  HR  LEND  OPS  MKTG

__Attendee __ Guest

Total ____

Total ____

Total ____

Early Bird Registration for Attendees (Deadline: October 1, 2010)

_____ @ $495 per attendee

= _____

Conference Registration for Attendees

_____ @ $525 per attendee

= _____

Conference Registration for Guests

_____ @ $175 per attendee

= _____

Leadership Council Workshops (Check the Council You Will Attend)

_____ @ $95 per attendee

= _____

Spouse & Guest Session: Historic Tour & Luncheon

_____ @ $80 per attendee

= _____

Offsite Sunrise Sailboat Cruise & Continental Breakfast

_____ @ $50 per attendee

= _____

LEVERAGE Golf Tournament (Includes Continental Breakfast & Lunch)

_____ @ $150 per player

= _____

Governmental Affairs Luncheon

_____ @ $50 per attendee

= _____

Includes Education Sessions, General Sessions, Continental Breakfast, & All Exhibit Hall Sessions

Includes Education Sessions, General Sessions, Continental Breakfast, & All Exhibit Hall Sessions

Total $____

Total ____

Total ____ Total ____

The following players would like to play in the LEVERAGE golf tournament:: Player’s Name

Credit Union Name

Handicap/ Average Score

Page 1 of 2

Payment Information Three Easy Steps to Register for the LSCU Development Conference

 Pay By Check  Pay By Credit Card

1. Carefully read, review, and complete this registration form.

 VISA  MasterCard

2. Fax credit card registration payments to Becki Payne at 205.991.2229.

Mail check registration payments to LSCU Development Conference, PO Box 380428, Birmingham AL 35238.

3. The registration process will be delayed if registration form is received without a check or credit card information.

Mail this form along with payment to: LSCU Development Conference PO Box 380428 Birmingham, AL 35238 Questions?

Call the Education Department at 866.231.0545, x2129 or email Becki Payne at becki.payne@lscu.coop.

Total $______ Total $______

CREDIT CARD AUTHORIZATION

__________________________________________________________________ Credit Card Number Expiration Date __________________________________________________________________ Cardholder’s Billing Address __________________________________________________________________ City/State/Zip __________________________________________________________________ Print Name __________________________________________________________________ Authorized Signature __________________________________________________________________ V Number (three digit number found on back of card)

Please make sure you fill out the entire registration form with attendee name, title, and email address so that all pertinent information can be managed prior to attendees arriving on property. See you in Point Clear!

The Early Bird registration deadline is Friday, October 1, 2010. All registrations received after this date will be charged at the regular conference registration rate. All cancellations must be in writing and received by the League of Southeastern Credit Unions prior to October 27, 2010, and will incur a $75 cancellation fee. No refunds will be issued for cancellations made on or after October 27, 2010, only substitutions.

Page 2 of 2