ANNUAL CONVENTION REGISTRATION
AGENCY OR COMPANY
Agency / Company ________________________________________ Contact ’ s Number ________________________________________
Contact Person _________________________ Contact ’ s Email _________________________
Attendee ’ s Name : Attendee ’ s Name Attendee ’ s Name
Full Registration |
�Mem . - $ 250 �Non-Mem . - $ 400 |
�Mem . - $ 250 �Non-Mem . - $ 400 |
�Mem . - $ 250 �Non-Mem . - $ 400 |
Monday Day Pass |
�Mem . - $ 175 �Non-Mem . - $ 275 |
�Mem . - $ 175 �Non-Mem . - $ 275 |
�Mem . - $ 175 �Non-Mem . - $ 275 |
Tuesday Day Pass |
�Mem . - $ 175 �Non-Mem . - $ 275 |
�Mem . - $ 175 �Non-Mem . - $ 275 |
�Mem . - $ 175 �Non-Mem . - $ 275 |
Wednesday Day Pass |
�Mem . - $ 175 �Non-Mem . - $ 275 |
�Mem . - $ 175 �Non-Mem . - $ 275 |
�Mem . - $ 175 �Non-Mem . - $ 275 |
Spouse / Guest |
�Mem . - $ 100 �Non-Mem . - $ 200 |
�Mem . - $ 100 �Non-Mem . - $ 200 |
�Mem . - $ 100 �Non-Mem . - $ 200 |
Socials Only |
�Mem . - $ 100 �Non-Mem . - $ 200 |
�Mem . - $ 100 �Non-Mem . - $ 200 |
�Mem . - $ 100 �Non-Mem . - $ 200 |
Tuesday Lunch Only |
�Mem . - $ 50 �Non-Mem . - $ 150 |
�Mem . - $ 50 �Non-Mem . - $ 150 |
�Mem . - $ 50 �Non-Mem . - $ 150 |
Amount $
* AFIS UPDATE REGISTRATION |
EARLY BIRD SAVINGS |
� TOTAL DUE : |
Take any two farm / ag breakouts to earn |
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your AFIS designation update . |
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PAYMENT OPTIONS � Check ( enclosed ) made payable to KAIA
Subtract $ 25 from full conference registration when you register by
DEC . 17
HOSPITALITY NIGHT SPONSORS
For all sponsorship opportunites visit kaia . com / annualconvention .
� Credit Card #_____________________________________ Exp . Date __________ CVV ______ �Visa � MC � Amex Billing Address ____________________________________ City ___________________ State _______ Zip ___________
$
Cancellation / Refund Policy . Requests received within 30 days or more of the event , will receive a 50 % refund . No refund will be issued for any cancellation requests on or after January 10 , 2022 . If you can no longer meet the COVID guidelines , please notify KAIA at your earliest convenience . Please review the COVID-19 guidelines before registering to ensure you can meet the requirements . Any approved refunds in full regardless of reason will be subject to a $ 30 processing fee . No refunds will be processed for “ no shows ”. Any other requests for cancellation beyond these guidelines will be assessed by KAIA and a refund will be granted on a case-by-case basis . All cancellations / changes must be made in writing .
Conference Attire . The conference is a business casual event . All after-hours events are casual . Send More , Save More : Send 3 + agents from one agency , save $ 10 per registration ( on top of EB discount )
How to Register : 1 . Mail : KAIA , 815 SW Topeka Blvd ., Topeka , KS 66612 2 . Fax : 785-232-6817 3 . Online : kaia . com / events
Register & choose your exhibit space at kaia . com / annualconvention
QUESTIONS ? CONTACT KAIA ! 800-229-7048 OR INFO @ KAIA . COM
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