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First Name:
Last Name:
Phone:
eMail:
Total Guests Attending:
(including yourself)
 

Please indicate which events you will be attending by checking the boxes below.

Thursday, October11th , 2007 - Meet & Greet/10-10-50 Presentation:
Friday, October 12th, 2007 - Conference:
Saturday, October 13th, 2007 - Conference:
Saturday, October 13th, 2007- Banquet:
 
Organization Affliation:
Other:
Are You a Vegetarian:
Yes
 
Comments:
   
Registration Fees: (Includes Breakfast, Lunch and Dinner)
By September 15, 2007
$125 (Student $65 )
After September 15
$150 (Student $75)
On Site
$175 (Student $85)

Please make your checks payable to: NATIONALIST Black Leadership Council

Mail to:

NATIONALIST Black Leadership Council
9 Gammon Avenue, SE
Atlanta, Ga 30315

 


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