INTERNET REGISTRATION FORM - Walk In Registration is OK!

Your benefit of pre-registration is badges will be ready at registration,

IBS 2013 Columbia College Chicago Radio/Webcasting Conference

Saturday, September 28, 2013

Columbia College Chicago

Host: Barbara Calabrese, Radio Chair, Columbia College Chicago

33 East Congress, Room C33

Chicago, IL 60605

ibs@ibsradio.org

Intercollegiate Broadcasting System (IBS)

367 Windsor Highway

New Windsor, NY 12553-7900

Phone: 845 565-0003 FAX: 845-565-7446 email: IBSHQ@aol.com

________________________________________

Please...

Print this form, fill it in and mail with your payment check.
For CREDIT CARD payments call IBS at 1-845-565-0003
VISA - MasterCard - Discover are accepted by IBS

(Advance FAX to 845-565-7446 for quick confirmation.

Return FAX IBS should send confirmation to: _________________________)

Your registration is not confirmed until we receive your check.

Mail to: IBS, 367 Windsor Highway, New Windsor, NY 12553-7900
(IBS Federal ID for your business office is: 23-705-9805)

Station Name/Call Letters:___________________________________________

School Name:_____________________________________________________

Station email address: _____________________

Station mailing address: __________________________ State: _______ Zip ________

Registration fee:

IBS member stations and High School Students: ___ $45 per person

Non-member stations: ___ $95 per person

Our payment check for _____ people in the amount of $______________
is enclosed or has been, or will be sent to:
Mail to: IBS, 367 Windsor Highway, New Windsor, NY 12553-7900

Please register the following people (please print clearly):

Person #1

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #2

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #3

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #4

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #5

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #6

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #7

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #8

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #9

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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Person #10

First Name:_________________ Last Name: ___________________

Person's Station Job Title for Badge: _________________________

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