TNG-CWA Residential Seminar for New Local Officers

Maritime Institute of Technology & Graduate Studies (MITAGS)

692 Maritime Blvd.

Linthicum Heights, MD 21090

March 11-14, 2016

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NOTE: This form must be completed and returned to TNG-CWA by Monday, February 29, 2016. Preference will be given to small and medium size locals. Use one form per participant. Please print clearly.

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Name & Number of Local: ______

Name of Participant: ______

Local office/position: ______

Home Mailing Address: ______

______

Job Classification: ______Department: ______

Phone: (H) ______(W) ______

E-mail address: ______

You will receive seminar information via e-mail only unless otherwise specified here? Via Postal Mail

Please check the appropriate box Smoking Non-Smoking

Single room (1 participant) $315.00 Subsidized

$630.00 Unsubsidized

Double room to share with another local with the same subsidy status. Please notify TNG-CWA as soon as possible.

$484.50 Subsidized ($242.25 /person/wknd) $969.00 Unsubsidized ($484.50 /person/wknd)

Double room to share with another local with different subsidy status. Please notify TNG-CWA as soon as possible.

$726.75 ($242.25 local with subsidy + $484.50 local without subsidy)

Double room to share with spouse or guest (The cost for your guest covers all meals for the weekend)

$315.00 Subsidized $630.00 Unsubsidized

$300.00 Guest $300.00 Guest

$615.00 $930.00

Fee Schedule for locals sending more than one participant:

Single room / Double room
2 Participants no subsidy = $1260.00 / 2 Participants no subsidy sharing a room = $969.00 ($484.50 per person/ per weekend)
2 Participants w/subsidy = $945.00 / 2 Participants (1 w/subsidy 1 w/o subsidy) sharing a room = $726.75 ($242.25 w + $484.50 w/o)

OR

Commuter ($200.00 per person for the weekend).

Payment in U.S. funds should be sent in advance and made payable to TNG-CWA. Participants are responsible for their incidentals and must present a credit card upon check-in. Please return this form along with payment to TNG-CWA Headquarters, 501 3rd Street NW 6th Floor, Washington, DC 20001 Attention: TNG-CWA New Local Officers Seminar.

TNG-CWA Residential Seminar for New Local Officers

Officer Signature______Date ______