Multi User Form Test – The National Federation of the Blind of Georgia

Name *

Email Address *

Phone Number *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Choose Your Convention Registration

Registration TypesRegistration Only ($35)Registration and Banquet ($80)

Lunch Preference *HamTurkeyVeggie

Registration TypesRegistration Only ($35)Registration and Banquet ($80)

Please choose your Banquet MealPasta RusticaFeta Stuff Chicken BreastSeared SalmonPlease note that the dessert for all Banquet meals is Key Lime Pie

Attend Senior Possibility Fair ($5)

Agenda Format *BrailleLarge PrintStandard PrintElectronic

YesNo