NCACAA 2016 Meeting Registration Form

After June 1, 2016 a late fee of $25 is added. Checks must be received by June 1 for early registrations.
No refunds will be given after June 5th.
If payment is not received by June 5th, registration may be canceled.
Tours subject to change.

Number	Rate	Membership Type/ Activities
	$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
	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
	Adults
	Under 12
Thursday Cookout (be sure to account for everyone attending a tour)
	Adults
	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

First Name
Last Name
Base County
Mailing Address
City
State
Zip
E-Mail
Phone	(include area code)
Cell	(include area code)
Spouse/Partner's Name	(if attending)
Children's Names/Ages	(if attending)

North Carolina Association of County Agricultural Agents

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

NCACAA Meeting 2016 Registration Form

Pre-Conference Team Building
Tuesday, June 21

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

Professional Development Tours
Thursday, June 23

North Carolina Association of County Agricultural Agents

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

NCACAA Meeting 2016 Registration Form

Pre-Conference Team Building Tuesday, June 21

Youth ActivityWednesday, June 2211:45 am - 5:00 pm

Professional Development Tours Thursday, June 23

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

Pre-Conference Team Building
Tuesday, June 21

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

Professional Development Tours
Thursday, June 23