November 12th, 13th and 14th, 2009
Pensacola, Florida

Registration Form

Price for civilian participants is $350.
Price for active duty participants is $250.
Price for Pensacola Bay Area Chamber Member is $250.

First Name
Last Name
Command/Company
Rank/Title
Address
City
State/Provience
Zip/Postal Code
Email
Telephone
Are you Active Duty Military?	Yes
Are you a Pensacola Chamber Member?	Yes
Pay by:	Credit Card Check
	Thursday, November 12, 2009      3:30 p.m. - 5:30 p.m.      Afternoon Keynote Session Thursday, November 12, 2009      5:30 p.m.      Opening Reception Saturday, November 14, 2009      Morning Golf Outing      A.C. Read Golf Course      NAS Pensacola      8:00 a.m. – Tee Time      7:00 a.m. – Departure from Hotel Saturday, November 14, 2009      Blue Angels Homecoming Air Show      NAS Pensacola      10:30 a.m. – Departure from Hotel

Payment in US Funds, drawn on a US bank, must accompany this for your registration to be processed. For additional registrations please make a copy of this form (each registration must be filled out separately)

Person’s under the age of 18 are not permitted at the Strategic Health and Intelligence Summit. Recording Devices and cameras, still or video, are prohibited.

You may cancel you registration to the event by October 12, 2009 for a full refund. After that date, you will receive a partial refund. If you are unable to attend the event, we recommend that you send a substitution in your place.

Please fax you cancellation/ substitution to (850) 438-6369 ATTN: Armed Services or e-mail to summit@pensacolachamber.com

If you have a disability and require special attention, please call us at (850) 438-4081 Ext. 227.

For an overview of hotel information please click here.

Questions? Please Call (850) 438-4081 Ext. 227 or Ext. 230