Early Bird Discount . Register by Friday , September 15 , and save $ 20 off each full conference registration . To claim your discount online , enter “ Early20 ” in the Discount Code field when registering .
Agency / Company _______________________________________________ Contact Person ____________________________ Best Phone Number to Contact You ______________________________ Email ______________________________________
Attendees q Member - $ 185 q Nonmember - $ 285 q Awards Dinner Only - $ 60
How to Register . Mail : KAIA , 815 , SW Topeka Blvd ., Topeka , Kansas 66612 Fax : 785-232-6817 Online : www . kaia . com
TAKE $ 20 OFF EACH FULL CONFERENCE REGISTRATION if you register by Sept . 15 . If registering online , use discount code Early20 NAME OF ATTENDEE TYPE OF REGISTRATION GOLF TOURNAMENT E & O CLASS
YOUNG AGENT OUTING AMOUNT DUE q Member - $ 130 q Nonmember - $ 250
q w / Conference - $ 50 q E & O Only - $ 100 q YA w / Conference q YA ONLY Member - $ 50 q YA ONLY Nonmember - $ 100 register by sept . 15 and save !
q Member - $ 185 q Nonmember - $ 285 q Awards Dinner Only - $ 60 |
q Member - $ 130 q Nonmember - $ 250 |
q w / Conference - $ 50 q E & O Only - $ 100 |
q YA w / Conference q YA ONLY Member - $ 50 q YA ONLY Nonmember - $ 100 |
q Member - $ 185 q Nonmember - $ 285 q Awards Dinner Only - $ 60 |
q Member - $ 130 q Nonmember - $ 250 |
q w / Conference - $ 50 q E & O Only - $ 100 |
q YA w / Conference q YA ONLY Member - $ 50 q YA ONLY Nonmember - $ 100 |
q Member - $ 185 q Nonmember - $ 285 q Awards Dinner Only - $ 60 |
q Member - $ 130 q Nonmember - $ 250 |
q w / Conference - $ 50 q E & O Only - $ 100 |
q YA w / Conference q YA ONLY Member - $ 50 q YA ONLY Nonmember - $ 100 |
Guest / Spouse Registration
NAME OF ATTENDEE TYPE OF REGISTRATION
AMOUNT DUE
Golf registrations must be received by September 25
golf preferRed foursome
Indicate who you wish to be paired with for the Golf Tournament
Name ___________________________ Handicap _______ Name ___________________________ Handicap _______ Name ___________________________ Handicap _______
hotel reservations Bluemont
1-785-473-7091 , $ 99.00 per night
Sponsorship oPPORTUNITIES
COMPANY NAME
Reservation Line : 1-785-473-7091 Address : 1212 Bluemont . Ave , Manhattan , KS Group Code : KAIA Deadline : Wednesday , September 13 Group Rate : $ 99 per night , including breakfast
q Awards Dinner Only ( Thursday evening ) - $ 60 q Guest / Spouse Full ( all meals , no classes ) - $ 100
GOLF TOURNAMENT
q Hole Tent ( provided by sponsor ) - $ 300 q Tee Sign Only - $ 250
YOUNG AGENT OUTING
q $ 250 q $ 500 q $ 1000
TOTAL DUE : method of payment q Check enclosed made payable to KAIA
q Credit Card #______________________________________ Exp . Date __________ CVV ______ q Visa q MC q Amex Billing Address ____________________________________ City __________ State ______ Zip ______
AMOUNT DUE
Cancellation / Refund Policy . 90 % of your registration fees may be refunded for cancellations received in writing by Sept . 25 . Half of your registration fees may be refunded for cancellations received in writing by Sept . 29 . Refunds cannot be issued for cancellations received after Sept . 29 .
QUESTIONS ? CONTACT MORGAN IN THE KAIA OFFICE AT 800-229-7048 OR MORGAN @ KAIA . COM
24 KANSAS INSURANCE AGENT & BROKER | July - August 2017 |
Register by Friday , September 15 , to get the best deal on registration fees !