Registration deadline is May 14th. Hotel bookings are needed by this date.

NCACAA Meeting 2010 Registration Form

Please fill in the following information:

First name
Last Name
County
Mailing Address
City
State
Zip
E-Mail Address
Phone	(include area code)
Cell	(include area code)
Spouse/Partner's Name
Children's Names/Ages

Number	Rate	Membership Type/ Activities
	$50	Members OR Guests
	$25	Spouse/Partner
	$25	Children (over 6)
	$0	Children (6 & under)
	$40	Life Member
	$25	Life Member Spouse
	$35	Banquet Only

* After May 14, 2010 a late fee of $25 will be added. Checks must be received by June 1 from early registrations.

Help us plan for meals
#	How many will be attending:
	Opening Luncheon (Adult)
	Opening Luncheon (Under 12)
Awards Banquet (Tuesday)
	10 oz. Ribeye
	Vegetarian Portobello Melt
	Pizza Party (not attending Banquet) - 6-9pm
	Grab & Go Breakfast (Wednesday)

Early Bird Activities Monday, June 14
Golf Outing Info Cost: $50 per player   Name (Last, First) Usual Score Desired Team Members Player 1: Player 2:
Professional Improvement Sessions Tuesday, June 15 1:30 - 2:20pm
	No. of Participants (spaces remaining)
Extension Agent 2.0	(30)
Ag Issues: NC Market Ready & Open Burning	Full
Are you a Peacock or just another Turkey?	(43)
Staying Connected Through Our Cell Phones	(29)
Professional Improvement Sessions Tuesday, June 15 2:40 - 3:30pm
	No. of Participants (spaces remaining)
Extension Agent 2.0	(52)
Ag Issues: NC Market Ready & Open Burning	(10)
Are you a Peacock or just another Turkey?	(23)
Staying Connected Through Our Cell Phones	(18)
Professional Development Tours Wednesday, June 16 $5.00 per person
	No. of Participants (spaces remaining)
Value Added Agriculture (3/4 day) Sanctuary Vineyards and the Weeping Raddish	(33)
Heritage Tourism (3/4 day) Currituck Heritage Park, Whalehead Club, Currituck Lighthouse	(38)
Nations Defense (3/4 day) US Coast Guard Station, potato farm	(35)
Nations Defense (1/2 day) US Air Force Bombing Range	(29)
Consumer Horticulture (1/2 day) Dare Arboretum and Nags Head Woods	(36)
Sustainable Agriculture (3/4 day) Alligator River Farms	(36)
Natural Resources (1/2 day) Alligator Wildlife Red Wolf Recovery Program	(34)
Economic Development (1/2 day) Wanchese Seafood Park	(49)
Youth Activities For Children 5 and older
Parents welcome	No. of Participants (spaces remaining)
Tuesday, June 15 9:00AM (join anytime) Beach Games	(19)
Tuesday, June 15 1:30PM - 4:30PM Aquarium and Mini Golf	(11)
Wednesday, June 16 8:00AM - Noon Jockey's Ridge	(26)
Wednesday, June 16 12:15PM Lunch @ McDonalds & Roanoake Island Festival Park (meal not included in registration - send money)	(34)
Will you need transportation for any Youth Activities?	Yes   No
Spouse & Life Members Activities Tuesday, June 15
	No. of Participants (spaces remaining)
Sanctuary Vineyard and Cotton Gin	(46)
Aquarium and Mall	(44)
Elizabethan Gardens	(41)

Please add any additional information here, such as the need for special food menus or handicap assistance etc:

When you have completed this form and everything is correct, click on the "Register" button below.
Mail a hard copy of the following page, along with your check made payable to NCACAA, to:

Katy Shook Chowan County Agricultural Center 730 North Granville Street, Suite A Edenton, NC 27932-1434