REGISTRATION FORM

Submit one form for each person registering

Convention registration does not include a hotel registration

Contact the Sheraton Music City for room reservations

ALL REGISTRATION INFO WILL BE KEPT STRICTLY CONFIDENTIAL-PLEASE PRINT CLEARLY

NAME: ______________________________________________ 0 SA 0 S-ANON 0 BOTH

ADDRESS:_______________________________________________________________________

CITY:_________________________________ STATE/COUNTRY _________________________

POSTAL CODE _______________ PHONE (with AREA CODE) __________________________

EMAIL__________________________________________________________________________

NAME TO APPEAR ON BADGE_____________________________________________________ CITY/HOME GROUP TO APPEAR ON BADGE________________________________________

(Home Group = Your Regular or Favorite Meeting) _______________________________________

ARE YOU WILLING TO DO SERVICE? (Check the area where you would like to offer assistance and a representative will contact you to match you with the convention needs.)

0Chair Meeting 0Registration 0Temporary Sponsor 0Fellowship Room

0Talent Show (This year featuring members from around the world) 0 General

PRE REGISTRATION FEE (CHECK ONE):
POSTMARK BY:	FULL CONVENTION with MEALS Includes Friday dinner, Saturday lunch & dinner!		FULL CONVENTION WITHOUT MEALS
BEFORE AUG. 1	0 $110	Choose Meal Option	0 $60
BEFORE DEC. 10	0 $120	0 Standard	0 $75
BEFORE JAN. 1	0 $135	0 Vegetarian	0 $90
All Registrations include Continental Breakfast Buffet Saturday and Sunday from 6:30am to 8:30am. This includes walk-ins!
Check Kosher meal availability by calling the Hotline or checking the Web Site after August 1, 2009!
WALK IN REGISTRATIONS:FULL WEEKEND $110 FRIDAY ONLY $35 SATURDAY ONLY $55 Unfortunately we cannot offer meal packages for Walk-In registrations but free beverage service will be supplied during meals.

Payment Method: 0 Check 0 Money Order 0 Credit/Debit Card

Amount being paid: $____________________ Make checks payable to: SANIC

Mail registration form to: SANIC P.O. Box 158746, Nashville, TN 37215

Card being used: 0 Visa 0 MasterCard 0 Discover Card

Cardholder Name: ________________________________________ Expiration Date ____________

Billing Address: __________________________________ City _____________________________

State/Country _____________________________________ Zip/Postal Code___________________

Card Number:_______________________________________________ Security Code__________

Signature ___________________________________________________ Date:_________________