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2016 NAIFA Convention - April 27-29, 2016
Astoria - 363 15th Street W, Dickinson, ND 58601
701-456-5000
Rooms must be booked by April 1, 2016
Rate: $79.99

         Please complete and remit with payment to: NAIFA-ND  *   1811 E Thayer Avenue    *      Bismarck, ND 58501

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

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

FIC      NAIFA-ND Fraternal Congress Non-Member

Early Registration: (before April 10, 2016)
Member            $150.00
1st Timer           $100.00

Additional Banquet Tickets - $30 each
           Banquet Tickets

Late Registration (After April 10, 2016)
         Member                 $175.00  
         1st Timer                $125.00

     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

            Enclosed is my  check in the amount of: