VAND Conference Registration Form

Help a Student:  I would like to support the Annual Meeting Student Scholarship program. Add $50 to VAND Conference Registration Form registration Donation to  Yes, I would like to contribute Name ______Credentials ______Hunger Free Hunger Free Vermont's mission is to end the injustice of hunger and malnutrition Vermont for all Vermonters. Company/School ______Go directly to Hunger Free Vermont donation page. Please let us know how much you donated so we can let Hunger Free Vermont know how much our Conference Academy Member # ______help inspire donations to this worthy cause. Your donation is tax-deductable through Hunger Free Vermont. https://hungerfreevt.kindful.com/ Address ______Total $ (add columns) City ______State ______Zip ______Credit Card Credit Card payment is available online through Pay Pal. If paying Payment Option through Pay Pal, please fill out this registration form and email the Daytime Phone #______completed form to [email protected] Email ______Monday Lunch Mixed Green Salad with Black Beans, Sweet Potatoes, Pickled Red Onion, Grape Option Tomato, Avocado, and Lime Vinaigrette. Please check Full Conference fees include breakfast, lunch and snacks on Monday, April 24, 2017, the exhibition & access to all one. sessions. Hotel registration & other hotel services not included. Please check the appropriate options below:  Grilled Chicken  Tofu Retired Membership Active Academy Member Academy Non-Academy Member Each meal also includes dessert and beverages. Type Member Please list any special dietary needs or allergies: or Contribute to  Yes, I plan to contribute to the Silent Auction. Please be sure to include your Student the Silent email or phone number above so we can contact you. Member Auction &  Yes, I give my permission for VAND to use any photographs taken at this event Registration Postmarked Postmarked On site Postmarked Postmarked Permission to that include me for promotional purposes of events and/or organization. Option Before 4/15 After 4/15 Before 4/15 After 4/15 or Photograph On site Full Conference  $115  $125  $135  $50  $155  $160 (Monday 4/24/17 all day) Half Conference  $80  $90  $100  $35  $100  $110 (Monday Morning Only +Lunch) Half Conference  $80  $90  $100  $35  $100  $110 (Monday Afternoon only +Lunch) Parking on UVM  $8.00 Email (if not provided above):______Campus (A parking pass will be emailed to you before the meeting)