IBS New York City REGISTRATION FORM - Walk In Registration is OK!


Pay by major credit card (VISA-MasterCard-Discover)

The Big Benefits of pre-registration are that YOUR ID badges will be ready, no waiting in line, FREE lunch

 

IBS/CUNY Kingsborough Community College Media Conference

Saturday, October 27, 2012

 

Kingsborough Community College

2001 Oriental Blvd.

Brooklyn, NY 11235

 

Intercollegiate Broadcasting System, Inc. (IBS)

367 Windsor Highway, New Windsor, NY 12553-7900 

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

 

Please print clearly, or type, this form and mail with your payment check.
  Or pay by major credit card (VISA-MasterCard-Discover)
call IBS 1-845-565-0003!

(Advance FAX to 845-565-7446 for quick confirmation.   Return FAX confirmation to: ________________)

Registration is $45 per person.  IBS Federal ID is: 23-705-9805

 

Station Name/Call Letters: ___________________________________________ 

 

School Name:_____________________________________________________

 

Station email address: _____________________

 

Station mailing address: __________________________ State: __ Zip ________

 

Registration fee: IBS member stations: ___ $45 per person;  Non-member stations: ___ $95 p/p

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 or YOUR Badge will be wrong):

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: _________________________

 

Available area hotel/motel lodging within a five-minute drive from the conference are:

        1. Best Western

            3003 Emmons Ave

            Brooklyn, NY 11235

 

        2. Comfort Inn

            3218 Emmons Ave

            Brooklyn, NY         11235