NCACAA 2016 Meeting Registration Form

North Carolina Association of County Agricultural Agents

2016 Annual State Meeting
Ramada Inn Nags Head Oceanfront
June 21-23, 2016


Registration deadline is June 1, 2016. Hotel rates guaranteed through May 22, 2016.

NCACAA Meeting 2016 Registration Form

First Name
Last Name
Base County
Phone (include area code)
Cell (include area code)
Spouse/Partner's Name (if attending)
Children's Names/Ages (if attending)
  Number   Rate Membership Type/
$75 Members & Guests
$35 Spouse/Partner
$25 Children (over 6)
$0 Children (6 & under)
$50 Life Member
$35 Life Member Spouse
$50 Banquet only
1 $25 Late Fee

Help us plan for meals & activities
Wednesday Opening Luncheon
Adults - Vegetarian
Under 12 (not attending Dolphin Cruise)
Under 12 - Vegetarian (not attending Dolphin Cruise)
Wednesday Supper
Attending Awards Banquet
Attending Awards Banquet - Vegetarian
Attending Youth Pizza Party
Thursday Communications Awards Breakfast
Under 12
Thursday Cookout (be sure to account for everyone attending a tour)
Under 12
Corn Hole Tournament Participants

2 players per team
Please list any dietary restrictions you may have (gluten free, etc.) :

Pre-Conference Team Building
Tuesday, June 21

See the state meeting home page for on-your-own opportunities.

Youth Activity
Wednesday, June 22
11:45 am - 5:00 pm

Youth under 9 should be accompanied by an adult
  No. of Participants
Educational Dolphin Tour (11)

Professional Development Tours
Thursday, June 23

Families invited

  No. of Participants
Cherry Farms Seed Co & Middle Creek Farms (15)
Bombing Range & Voluntary Agriculture District (16)
Sanctuary Vineyards & Weeping Radish (14)
Wanchese Seafood Park & O'Neals (5)

Please add any additional information here, such as handicap assistance etc:

When you have completed this form and everything is correct, click on the "Register" button below.
Mail a hard copy of the following page, along with your check made payable to NE NCACAA and send to:
Katy Shook, NENCACAA Treasurer
Chowan County Extension Center
730 North Granville St, Ste A
Edenton, NC 27932