First Name (required)

Last Name (required)

TCCNA Title:

Chamber of Commerce:

Gender: Male Female

DOB

Dietary Preference:

Address:

Tel:

Fax:

Cell:

E-mail:

TCCNA 2019~2020 FEE:
Paid Unpaid

Partners

Name ( Same as Photo ID )

Gender

Relationship

Dietary Preference

Attendance fee

1. The TCCNA of directors and Supervisors and above who have paid the 2019 – 2020 member fee s are exempt from payment.

2. D irectors and Supervisors and above are carrying spouses or direct family me mbers, and the first person is present for free. The attendance fee for the second person is the same as non – supervised supervisor.

3. We will charge 350 dollars per person for non – supervisory supervisors, members and non – members.

Flight

Pick-up: Yes No

Flight number:

Arrival time:

AM PM

Pick spot:

Drop – off: Yes No

Arrival time:

AM PM

Hotel

Check – In :

Check – Out

Confirmation #:

Bellagio Resort & Casino Add: 3600 S Las Vegas Blvd, Las Vegas , NV 89109 Traditional Room : USD $ .00 +tax

Please check 10 / 31 – 11 / 03 programs that you would like to participate, you will be charged whether you attend or not.

10 / 31 ( Thu ) Dinner :

Attendees

11 / 01 ( Fri ) Golf tournament:

Attendees ( Another applic ation form )

11 / 01 ( Fri ) Dinner:

Attendees

11 / 02 ( Sat ) Lunch:

Attendees

11 / 02 ( Sat ) Dinner:

Attendees

11 / 03 1Day trip:

Attendees (Another application form)

11 / 04 5Days trip:

Attendees (Another application form)