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2011 NAIFA Convention
January 31 - February 2, 2011

Radisson Inn
605 E Broadway
Bismarck, ND
701.255.6000
Please contact the Radisson Inn to make your reservations and state that your are with NAIFA
Reservations must be made prior to January 10th.

Please complete and remit with payment to: NAIFA-ND
        PO Box 5010
        Bismarck, ND 58502

To pay by Credit Card . Click Here Please complete registration and fax (701.222.0103) or mail to NAIFA-ND. If you have questions, send an email to info@naifa-nd.org

I am a member of (Please check all that apply)

FIC      NAIFA-ND Fraternal Congress Non-Member

Early Registration: (before January 10, 2011)
Member              $150.00
Non-Member     $350.00
 

Additional Banquet Tickets - $25 each
           Banquet Tickets

Late Registration (After January 10, 2011)
         Member                 $175.00                       Non-Member        $375.00

Please print Name exactly as you would like it to appear on your name badge.

Name          
Designation(s)
Company       
Address       
C/S/Z          
E-mail        
Tel           
FAX              
   Enclosed is my
      check in the amount of: