Registration Form



Registration FormNATIONAL CONFERENCE OF GOVERNOR’S SCHOOLSGeneral MeetingOctober 8-10, 2015Samford UniversityBirmingham, AlabamaRegistration fees?On or before September 25: $250 (includes $75 for dues)?After September 25: $260 (includes $75 for dues)________________________________________________________________________Name (please type or print)LastFirstM.I.________________________________________________________________________Home AddressCityStateZip________________________________________________________________________Governor’s SchoolOccupation/Job Title_____________________________________________________________________Business AddressCityStateZip(___)______________________________ (___)________________________________Home PhoneBusiness Phone?Enclosed is my check/money order, payable to NCoGS, for $ ______________REGISTRATION INCLUDESThursday, October 8Opening reception at Hampton InnDinner at the Fish Market Friday, October 9Lunch at Samford UniversityDinner at President and Mrs. Andy Westmoreland’s homeSaturday, October 10Lunch at hotel catered by Full Moon Barbecue of Birmingham Civil Rights Institute HYPERLINK "" : requires at least 25 people for discounted rateROOM RESERVATIONSThe conference hotel is Hampton Inn Birmingham/Mountain BrookThe address is 2731 US Highway 280 SouthBirmingham, AL 35223The phone number is 205-870-7822Hotel web site register, please use the conference web site note that the rooms will be held until September 25.The rate is $99.00 per person plus taxes. Breakfast is included in the price.TRANSPORTATIONThe hotel is located on US Highway 280 South. The sign is difficult to see, but you can look for the Wendy’s restaurant located next door to the hotel.The Birmingham Airport is served by the following airlines:American AirlinesDelta AirlinesSouthwest AirlinesUnited AirlinesUS AirwaysRental Cars are available at (or near) the airport from the following agencies:Alamo Rent A CarEnterprise Rent A CarAvis Rent A CarHertz Rent A CarBudget Rent A CarNational Rent A CarDollar Rent A CarThrifty Rent A CarTaxi/shuttle service is available to both hotels for about $25 one way.Mail form and full payment to Dr. George KellerAlabama Governor’s SchoolSamford University Birmingham, AL 35229-3742- or -Fax your registration to (205) 726-2479. ................
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