112th Credit Congress Second Chance Form

Education

Emergency Contact Form

112th Credit Congress Second Chance Form
May 18-21, 2008 • Louisville, KY

This "Second Chance" form gives you the opportunity to add on to your existing registration.
Please use this form to add any additional activities such as luncheons, tours, etc.

* Indicates a required field

I. Delegate Information
* First Name or Nickname (for badge):


* Full Name (include professional designations):


* Company Name (please provide complete name):


* Address (please include mail stop, floor, etc.):


* City:	* State/ Province:


* Zip/ Postal Code:	Country:


Main Telephone Number:	* Email Address:

II. Spouse/ Guest Information
First Name	Last Name

III. Child Registration Information
First Name	Last Name

Fee Schedule:
Member Fee Schedule
	Spouse/ Guest	$189
	Child	$169

Non-Member Fee Schedule
	Spouse/ Guest	$209
	Child	$169

Optional Educational Sessions: (Fees are in adddition to Full Delegate Registration)
	$249	Business Credit Principles Certificate Session
	$249	Financial Statements Certificate Session
	$35	Mentor Training Workshop
	$45	CBA Exam Review Session
	$45	CBF Exam Review Session
	$45	CCE Exam Review Session

Optional Networking Events:

Saturday, May 17:

$59

Louisville Slugger Museum Designee and GSCFM Alumni Event

Sunday, May 18:

$125

NACM Scholarship Foundation Golf Outing

Monday, May 19:
(Please select only one of the following two, they run concurrently)

$65

FCIB Luncheon

$55

International Utilities Group Luncheon

Tuesday, May 20:

$55

CFDD Luncheon

Wednesday, May 21:

$75

Closing Night Party (additional ticket)

Optional Tours:

Sunday, May 18:

$65

Brunch, Rivers & Bridles Tour

Monday, May 19:

$60

Maker's Mark & Historic Bardstown Tour

Special Offers:

$99

Conference Sessions CD-ROM Package (Pre-show price)

I want to support the education of our industry by contributing to the NACM Scholarship Foundation. Please include my contribution in my total.

$10

$25

$50

$100

$200

Click here , if you would like to donate an amount not listed.

*Indicates a required field

Total:

Payment Information:

Please charge my:

* Card Number:

* CID:

* Expiration Date:

* Printed Name (as it appears on card):

Billing Address (if different from above):

NACM Tax ID# 52-1972771

Click here for W9-form

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©2008 National Association of Credit Management
National Association of Credit Management
8840 Columbia 100 Parkway
Columbia, Maryland 21045-2158
Phone: 410.740.5560