CONVENTION REGISTRATION
Alabama Independent Insurance Agents
121st ANNUAL CONVENTION & TRADE SHOW
June 7-9, 2017
Hotel Reservations MADE DIRECTLY with Hilton Sandestin Beach Group Reservations CODE: AII
Reservation: Phone: 800-367-1271 Fax: 850-267-3076 Book Hotel online: www.sandestinbeachhilton.com
COMPLETE ONE (1) REGISTRATION PER INDIVIDUAL OR FAMILY
Agency/Company Name:_______________________________________________Phone:__________________________
Address:________________________________________________E-mail:______________________________________
Street/PO Box
City/State/Zip
Name:_____________________________________________________________Designations:______________________
BOGO Name:_______________________________________________________Designations:____________________
Spouse/Guest Name:__________________________________________________________
First Time: __Y __N
Name/s & Age/s of Children:___________________________________________________
Exhibitor: __Y __N
Sponsor: __Y __N
Full registrations include ALL events and scheduled meals.
AGENT
____Agency Member
____BOGO – (Additional Licensed Agency Member)
____1st Timer, Young Agent, Retired Agency Member
____Spouse/Guest of Agency Mbr (Cannot be licensed agent or company representative)
____Non-Member Agent
Children 15 – 17
Fee per person
$250 $______
$ -0- $_-0-__
$210 $______
$100 $______
$270 $______
$ 75 $______
ASSOCIATES/COMPANIES/ EXHIBITORS/SPONSORS
____ Associate Member/Exhibitor/Sponsor
____Spouse/Guest of Associate Member
Fee per person
$269 $______
$160 $______
(Cannot be a licensed agent or company representative)
____Non-Member Company Representative (Not Exhibiting or Sponsoring)
____Additional Exhibitor Representative – TRADE SHOW ONLY
Children 15-17
CHILDREN’S SCHEDULED PROGRAMS
$469 $______
$150 $______
$ 75 $_____
BOGO
For
Member Agency:
Register 1st agent
Send
nd
2 licensed agent
from same agency
For
NO registration fee.
Use downloaded
Registration Form
to register.
For Children 5 – 14 years of age
There is no registration fee.
Parents registered for the convention are asked to utilize the Hilton Children’s Programs. (Ages 5-12)
Please provide receipt or copy of hotel bill showing charge(s) to Irene or Nancy - AIIA will reimburse up to a total of $100.
You may choose from time table listed below for your $100 credit.
o Wednesday, June 7
6:00p – 10:00p
o Thursday, June 8
9:30a – 1:30p
o Friday, June 9
6:00p – 10:00p
The Hilton Sandestin has a recreation center on ground floor of the hotel. See hotel children’s activities.
Hilton recommended Babysitters at the Beach (850) 259-7909 www.babysittersatthebeach.com
Call sitting services EARLY before convention for reservations.
TOTAL AMOUNT DUE:
$__________
VISA/MasterCard/Amex Card#_______________________________________Exp Date:__________
Name on Card:_________________________________________________________________________
Checks Payable & Registrations mailed to: AIIA/141 London Pkwy/Birmingham/AL/35211
REFUND POLICY: Request in writing. Cancellation processing fee: $50. NO REFUNDS after May 8th, 2017.
Questions? Contact Nancy Crowe ([email protected]) Phone: (205) 326-4129, Ext. 103 Fax: (205) 326-3086
REGISTRATION FORMS AVAILABLE ON-LINE AT www.aiia.org
AIIA Convention is located at Hilton Sandestin Beach Golf Resort & Spa, Destin, Florida