For more conference information, send an e-mail to: firstname.lastname@example.org. Step 1 of 2 50% NGAI 2017 Annual Conference RegistrationPlease fill out the form below to register for this event. THE REGISTRATION DEADLINE IS 17 APRIL 2017. For more info call 317-247-3196.Name* First Initial Last Rank*Enter NONE if not applicable - Rank will be on your name badgeName for Badge*Name you want on your conference badgeAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Spouse/Guest NameFirst - MI - Last - RankGuest Badge NameName you want on your guest's conference badgeEmail* Your PERSONAL email address (no military emails)Home PhoneCell Phone*Work PhoneEmployerJob TitleWork E-mail AddressComponentNoneARMY/ARNGAIR FORCE/ANGOTHER MILITARYCORPORATESelect oneTypeNoneAGRTraditionalTechnicianSelect all that apply (Use "CTRL+click" to select more than one)StatusNoneRETIREDACTIVECIVILIANSelect oneNGAI Member GroupNoneJFHQ181 IW122 FW38th HQ38th CAB38th SUST76th IBCT81st TC219th EN BDECAMCCOSelect oneChoose your conference activity or activities from the drop down menus on the next page.Each menu allows for up to 4 attendees to be registered for each event. THIS CONFERENCE HAS A TIERED REGISTRATION FEE. You MUST select one of the following options in order to be able to continue with the form and to be given the proper payment options. Fee is per person attending. Includes State's Dinner and access to exhibit hall and silent auction area.Select one of the following:*Non-NGAI Members or Exhibitor OnlyCorporate PartnersE9, W4/W5, O4 & upO1 to O3, W1 to W3, E7/E8E6 & below Conference and Event SelectionsThe conference registration fee is per person attending and includes States Dinner and access to Exhibit Hall and Silent Auction area.Non-Member/Corporate Partner/Exhibitor Registration Fee - $95NONE1 attendee - $95.002 attendees - $190.003 attendees - $285.004 attendees - $380.00Eagle Sponsor - 1 attendeeEagle Sponsor - 2 attendeesEagle Sponsor - 3 attendeesEagle Sponsor - 4 attendeesPatriot Sponsor - 1 attendeePatriot Sponsor - 2 attendeePatriot Sponsor - 3 attendeePatriot Sponsor - 4 attendeeMinuteman Sponsor - 1 attendeeMinuteman Sponsor - 2 attendeeMinuteman Sponsor - 3 attendeeMinuteman Sponsor - 4 attendeeNON-NGAI MEMBERS & CORPORATE PARTNERS/EXHIBITORS (see drop down for your level)Conference Registration Fee - $95.00None1 attendee - $95.002 attendees - $190.003 attendees - $285.004 attendees - $380.00E9, W4/W5, O4 & UPConference Registration Fee - $70.00None1 attendee - $70.002 attendees - $140.003 attendees - $210.004 attendees - $280.00O1 to O3, W1 to W3, E7/E8Conference Registration Fee - $50.00None1 attendee - $50.002 attendees - $100.003 attendees - $150.004 attendees - $200.00E6 & belowGolf Outing - NGAI Members & Corp PartnersNONEGolf-1 attendee - $105.00Golf-2 attendees - $210.00Golf-3 attendees - $315.00Golf-4 attendees - $420.00Golf-Eagle - 1 attendeeGolf-Eagle - 2 attendeesGolf-Eagle - 3 attendeesGolf-Eagle - 4 attendeesGolf-Patriot - 1 attendeesGolf-Patriot - 2 attendeesGolf-Patriot - 3 attendeesGolf-Patriot - 4 attendees $105Golf-Minuteman - 1 attendeeGolf-Minuteman - 2 attendeeGolf-Minuteman - 3 attendees $105Golf-Minuteman - 4 attendees $210Golf Outing - Non-NGAI MembersNONEGolf-1 attendee - $125Golf-2 attendees - $250Golf-3 attendees - $375Golf-4 attendees - $5005K Fun Run - $255K NONE5K 1 attendee - $255K 2 attendees - $505K 3 attendees - $755K 4 attendees - $100Includes T-shirt, medal, awardsWho will be running in the 5K?AttendeeSpouse/GuestBothSelect one optionShirt size for 5k run (S, M, L, XL, XXL)Enter your size(s) separated by a commaBusiness meeting onlyML NONEML 1 attendee - $25ML 2 attendees - $50ML 3 attendees - $75ML 4 attendees - $100If attending just the Business Meeting/Lunch. Per person.Exhibitor Lunch (additional) - $25EL NONEEL 1 attendee - $25EL 2 attendees - $50EL 3 attendees - $75EL 4 attendees - $100See Exhibitor Registration for Details. Per person.Retiree luncheon w/MG Carr - $25RL NONERL 1 attendee - $25RL 2 attendees - $50RL 3 attendees - $75RL 4 attendees - $100Spouse/Guest brunch at Sinclair's - $35NONE1 attendee - $352 attendees - $703 attendees - $1054 attendees - $140Per person. Saturday 10:30am at Sinclair's.Spouse/Guest Event Option #1 (lunch included) - $50NONE1 attendee - $502 attendees - $1003 attendees - $1504 attendees - $200Per person. Friday 10am - 2pm. Small Arms Defensive Course/Live Firing.Spouse/Guest Event Option #2 - $40NONE1 attendee - $402 attendees - $803 attendees - $1204 attendees - $160Wilstem Ranch; elephant & giraffe seminarTotal $0.00 NOTE: Sorry, due to the form requirements, you must fill out credit card info even if your balance is ZERO.Credit Card Billing Address* Same as address above Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name Please only hit SUBMIT once. It may take a moment to process your registration. You will get a message when the process is complete.NameThis field is for validation purposes and should be left unchanged.