Please Complete for Your Institution and Submit to Jerry Berberet with Payment by May 1.

Institute Fees:

• ANAC Member Institutional Team Registration (3-5 persons = $600; each person over 5, add $150)
  
• ANAC Member Individual Participant Registration (1-2 persons @ $250/person)
  
• Non-ANAC Member Participant Registration ($300/person)
  
• Meals, Lodging, Breaks, and Receptions at Hampton University ($325/person)
  
• June 20 Spirit of Norfolk Evening Dinner Cruise and Entertainment ($50/person)

INSTITUTION NAME _________________________________________________________
COMPLETE ADDRESS ________________________________________________________
CONTACT PERSON _____________________________ TITLE ______________________
PHONE ____________ FAX _______________ EMAIL ____________________________

PLEASE REGISTER EACH PARTICIPANT FROM YOUR INSTITUTION BELOW:

#1.
Name Tag Name:
#2
Name Tag:
#3
Name Tag:
#4
Name Tag:
#5
Name Tag:
#6
Name Tag:
#7
Name Tag:

TOTAL ANAC TEAM REGISTRATION FEES $______________
TOTAL ANAC INDIVIDUAL REGISTRATION FEES $______________
TOTAL NON-ANAC MEMBER REGISTRATION FEES $______________
TOTAL LODGING, MEALS, BREAKS, & RECEPTIONS ($325/PERSON) $______________
TOTAL SPIRIT OF NORFOLK DINNER CRUISE RESERVATION FEES $______________
TOTAL INSTITUTE PAYMENT $______________

SPECIAL NEEDS (Vegetarian Meals, Disability Access, etc.) ______________________________________ __________________________________________________________________________________________

RETURN COMPLETED REGISTRATION FORM by MAY 1, with CHECK PAYMENT MADE OUT:
"ASSOCIATED NEW AMERICAN COLLEGES" to Jerry Berberet, 2248 Sailfish Drive, St. George Island, FL 32328. Questions? Call Jerry at 850-927-3948, or email: anacjberb@aol.com.