Online Registration Form

March 16-18, 2012
Seventh Annual GFIA Conference
Raleigh, North Carolina, USA


Use this form if you would like to register online and pay with PayPal. After you submit the form, you will be directed to a page where you will complete your secure PayPal payment.

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Personal Information:

* = Required Field

Name(s) *



Street Address *
Address (cont.)
City *
State/Province *
Zip/Postal Code *
Country *



Cell Phone #
Other Phone #
E-mail Address *

Options:

Number of people attending:

Members @ $20 per person (entire conference)
Nonmembers @ $30 per person (entire conference)
Students @ $15 per person (entire conference/does not include Saturday dinner)
1-Day Only (Fri-March 16) Members or Nonmembers @ $10 per person
1-Day Only (Sat-March 17) Members or Nonmembers @ $10 per person
1-Day Only (Sun-March 18) Members or Nonmembers @ $10 per person

Participation in all conference activities, Friday & Saturday lunches, Saturday dinner, and daytime snacks are included in all fees.
Call 979-540-6448 or email president@guineafowlinternational.org for special requests, such as children attending.


Do you need help with:

~ a ride from the airport?

Yes
No

~ finding a roommate?

Yes
No


Do you have:

~ guinea fowl?

Yes
No

How many?


~ chickens?

Yes
No

How many?


~ other birds? Specify:


Question? Comment?

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