National Black Farmers Association Conference 2014

24th Annual NBFA Conference (November 7-8, 2014)
Conference Registration Form
Full Name

First Name Last Name
Address

Street Address

City State / Province

Postal / Zip Code Country
Phone Number

Area Code Phone Number
E-mail
Pre-registration is required. First 100 registered participants will receive a Complimentary (Free) Banquet Ticket.

We must have the names of every person attending the conference. Please use the additional "Participant 2" and "Participant 3" Name(s) to register anyone who is traveling with you to the NBFA Conference.
Participant 2

First Name Last Name
Participant 3

First Name Last Name
Hotel Lodging Registration is the responsibility of each conference participant.

TO BOOK YOUR ROOM PLEASE CALL:

Jacksonville Airport Hotel

2101 Dixie Clipper Road

Jacksonville, Florida 32218

Telephone: (904) 741-1997

Room Rate: $85/per night plus taxes (Queen Double or King Room) if reserved by 10/14/2014. Reservations received after that date will be charged standard room rates.

Conference Hotel Room Reservation Code: NBFA
Should be Empty:

24th Annual NBFA Conference (November 7-8, 2014)