Newborns in Need
5th Annual National Convention, 2005
“VOLUNTEERS - the Flowers in GOD’s Garden of LOVE”

April 14 - 16, 2005

This year’s convention is being held at

Fountain of Life Lutheran Church
710 South Kolb Road
Tucson, Arizona

Name:

Address:

Phone: (day):

(evening):

Chapter Name:

Board position:

Volunteer (what do you like to do most for the babies)?

Other:

How long have you been volunteering for NIN?

Please provide us with this information:

Arrival:

Mode of transportation:

Rooming with:

MEAL INFORMATION:  Friday and Saturday lunch provided.  In addition we will have a snack table open all day both days with healthy and Southwestern delicious foods. Meals will be served buffet style.

Special diet:  If yes please explain:

PLEASE CIRCLE YOU CHOICE FOR THE FRIDAY NIGHT DINNER

Filet Mignon           Wrangler Burger                 Veggie Burger                   BBQ

Chicken                   Grilled Marinated Chicken Breast                                 Salmon Filet

Open Range Platter (Thinly sliced Pit Beef with mashed potatoes & gravy, corn on the cob & biscuit)

THE ABOVE IS SERVED WITH SALAD, BREAD AND OUR FAMOUS RANCH BEANS

If you wish a baked Potato with your meal please circle  BAKED POTATO

If submitting registration online, please enter dinner selection and options here:

Advanced Payments: The registration fee for the 2005 Annual Convention will be $25.00.  All payments should be sent:

            NIN Home Office
            P.O. Box 385
            Houston, MO 65483.

Please make your checks or money orders payable to Newborns In Need, Inc.,

Attn:  2005 Convention.  You may pay via the internet through www.paypal.com sent to the email address of home@newbornsinneed.org.  If you wish to send additional funds as a donation to help with convention along with your payment, please feel free to do so. A tax-deductible receipt is available upon request.

The Southern Arizona Chapter would like for you to send us a picture of yourself from the age of Newborn to 5 years old.  We will return the picture to you.  You can e-mail this picture to us at sarizona@newbornsinneed.org or sewkaren@hotmail.com if you wish and please don’t forget to give us your name. We would like to make our place settings with your baby picture on it. If you do not have a photo release form signed by you at the home office please sign one and send it in.  When the convention starts we will take a picture of you at that time if we have not received a baby picture from you.

A few notes about the convention: While this is an adult convention, nursing and newborn babies are joyfully welcome.

Please use one of the following options to submit this registration:

1. Complete this form online and press the SUBMIT button at the bottom of the page. However, this option may not work if Outlook is not your default email program.  If you are uncertain whether or not Outlook is your default program, please use option 2 or 3.

2. Print this form and mail it to NIN Home Office, PO Box 385, Houston, MO 65483

3. Cut and paste this form into an email message and email to home@newbornsinneed.org

We will send you a confirmation email when we have received and processed your registration entry.

Thank you. See you here!!