NURSES MARDI GRAS CONFERENCE IN THE PORT CITY OF MOBILE, AL

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NURSES MARDI GRAS CONFERENCE IN THE PORT CITY OF MOBILE, AL Marriott Renaissance Mobile Riverview Plaza Hotel 64 S. Water Street, Mobile, AL 36602 Telephone: 251.438.4000 SAVE THE DATE February 5 7, 2016 REGISTRATION OPEN Nurses, nursing students, guests/family are invited to attend for CEUs, networking and fun! Registration Fee: $175/member* $200/non-member or guest Students (undergraduates; must present current student ID): $75/member* $100/non-member Registration: includes CEUs, Friday luncheon, Saturday breakfast, Sunday brunch, hospitality room snacks and drinks Late Registration: add $25 if registering after January 3, 2016. ** Mobile Area Mardi Gras Association (MAMGA) Ball tickets: $50/person ** Crewe of Columbus Ball tickets: $50/person ** Casino Trip: $25/person (receive $15 free play) Tentative Itinerary: FRIDAY, FEBRUARY 5, 2016 10:00am 11:00am Registration 11:00am 12:00pm Welcome & Luncheon 12:00pm 2:00pm Opening Session CEU Presentation (2) 2:00pm 2:15pm Break, Visit Exhibitors & Posters 2:15pm 3:15pm Presentation (1) 3:15pm 3:30pm Break, Visit Exhibitors & Posters 3:30pm 4:30pm Presentation (1) 4:30pm Reception, Visit Exhibitors & Posters Crewe of Columbus 9:00pm MAMGA Ball, Mobile Convention Center (optional; separate charge)** (Formal attire is required. Limited tickets are available, so please register in advance.) 9:00pm Crewe of Columbus Ball, Mobile Civic Center (optional; separate charge)**

SATURDAY, FEBRUARY 6, 2016 7:30am 8:00am Registration and Visit with Exhibitors 8:00am 9:30am Breakfast & CEU Presentation (1.5) 9:30am 9:45am Break, Visit Exhibitors & Posters 9:45am 10:45am CEU Presentation (1) 10:45am 11:00am Break, Visit Exhibitors & Posters 11:00am 12:00pm Open Forum 12:00pm 2:30pm Bus Trip to Casino (optional; separate charge)*** 7:00pm-10:00pm Hospitality Room Open 12:00am Bus Returns to Hotel SUNDAY, FEBRUARY 7, 2016 8:00am 10:30am Church Service 11:00am 2:00pm Farewell Mardi Gras Brunch CEU & Talent Show Presentation 2:30pm Joe Cain 5:00pm 5:30pm Super Bowl 50 th Reception, Hospitality Suite MONDAY, FEBRUARY 8, 2015 12:00pm 3:00pm MLK 7:00pm 8:00pm-12:00am Hospitality Room Open FAT TUESDAY, FEBRUARY 9, 2016 10:30am 12:30pm 2:00pm MAMGA **Tickets to special events must be purchased with registration to reserve a seat. Tickets sell out fast. * Members of MBBNA, MBNA, NBNA and ASNA receive member discount. REGISTRATION To register for the Mardi Gras Conference, please complete the attached form and mail, along with check or money order. Make check or money order payable to: Nash Travel Mail to: Nash Travel 325 Claxton Way Birmingham, Alabama 35064 WHAT S INCLUDED IN YOUR CONFERENCE REGISTRATION FEE Welcome Luncheon on Friday, February 5th All education sessions All breaks Exhibitors Show Breakfast on Saturday, February 6th Mardi Gras Brunch on Sunday, February 7th Printed:11.01.2015 2

MARDI GRAS REGISTRATION CANCELLATION POLICY: To receive a refund of the registration fee, a written request must be received by January 3, 2016. No refunds will be made after this date. Cancellation must be in writing to Felita Watkins felita.nashtravel@gmail.com. ***WHAT S INCLUDED WITH YOUR CASINO TRIP Roundtrip bus ride to Hard Rock Casino $15.00 free play HOTEL RESERVATIONS A room block has been reserved at the Marriott Renaissance Mobile Riverview Plaza Hotel. Hotel reservations within the room block can not be placed without payment of the registration fee. To book your reservation, contact Felita Watkins at felita.nashtravel@gmail.com or contact the hotel after payment of your registration fee at 251.438.4000. The hotel will be provided with a list of the registrants. Hotel rooms within the room block are on a FIRST COME FIRST SERVED basis. Rooms will no longer be available within room block after JANUARY 3, 2016. Registrants are personally responsible for hotel fee and applicable charges. Group Room Rate of $209.00 plus tax for Friday, February 5th and Saturday, February 6 th, Standard 1 King or 2 Queen Guest Room Group Room Rate of $169.00 plus tax for Sunday, February 7 th and Monday, February 8th, Standard 1 King or 2 Queen Guest Room 1 Day Pre (February 4 th ), 2 Day Post (February 9th, 10 th ) at a Reduced Rate of $169- Based on Hotel s Group Availability Discounted Self-Parking at $7.00 per day INDIVIDUAL HOTEL ROOM CANCELLATIONS: Individual room reservations may be cancelled by January 3, 2016 with no cancellation penalty. Cancellations after January 3, 2016 will cause forfeiture of the one night room deposit. Cancellation must be in writing to Felita Watkins felita.nashtravel@gmail.com. For more information contact Felita Watkins at felita.nashtravel@gmail.com or Chair, Carthenia Jefferson at cwjefferson@jeffersonlawfirmllc.com. Printed:11.01.2015 3

REGISTRATION FORM Name: License Number: Address: City: State: Zip: Telephone: Email: Check all that apply 1) Registration Fee: ASNA student members- $75; non-member students-$100; members of ASNA, MBBNA, MBNA, BBNA - $175; non-members $200; members one day registration $100; non-members one day registration $125. Late registrants add $25 if registering after January 3, 2016. I am a member of the Alabama State Nurses Association (ASNA)* I am a member of the Mobile Bay Black Nurses Association (MBBNA)* I am a member of the Montgomery Black Nurses Association (MBNA)* I am a member of the National Black Nurses Association (NBNA)* I am a member nursing student I am a non-member nursing student I am a presenter Non-member 2) Participation: I will attend Education Sessions Friday Saturday Sunday (check day/s will attend) Abstract Presentations Friday, February 5 th, Welcome Luncheon - Number attending (one (1) ticket included in registration; each additional ticket $50) Saturday, February 6 th, Breakfast - Number attending (one (1) ticket included in registration; each additional ticket $35) Sunday, February 7 th, Farewell Mardi Gras Brunch - Number attending (one (1) ticket included in registration; each additional ticket $50) MAMGA GRAND MARSHAL BALL; Number attending (separate charge of $50/person) CREWE OF COLUMBUS BALL; Number attending (separate charge of $50/person) CASINO TRIP; Number attending (separate charge of $25/person) TOTAL AMOUNT ENCLOSED $ checks or money orders only. To register by credit card complete the information below. 3) Please add me to the Nurses Mardi Gras Conference room block for the following nights: (check all that apply) Thurs., Fri., Sat., Sun., Mon., Tues. Number of Beds: Standard 1 King bed 2 Queen Double beds Printed:11.01.2015 4

FORM OF PAYMENT: Check, Money Order or Credit Card (3% convenience fee) Make check or money order payable to: Nash Travel Mail to: Nash Travel 325 Claxton Way Birmingham, Alabama 35064 By signing the form below, I am authorizing Nash Travel to withdraw the funds for the 2016 Nurses Mardi Gras Conference from the financial institution I have designated and I agree to pay a 3% convenience fee. Name: Address: City: State: Zip: Phone Number: Authorized Signature: Bank Name: Card Number: Date: CVC: Exp. Date: Printed:11.01.2015 5