input.xss {display:none;} 2011 CUNA Lending Council Conference Registration


17th Annual
CUNA Lending Council Conference
November 6-9, 2011
New Orleans, LA

Print this form and mail with check, or fax with credit card to:

Credit Union National Association
CUNA Lending Council
Box 78546
Milwaukee, WI 53278-0546
FAX (608) 231-4327

Note: payment must accompany form. Due to processing and delivery, receipt can take up to two weeks for mail orders.

If you are a vendor, please complete this form after first sponsoring an event. For details, click here.

You can also fill out this form to register online with your credit card (this is a secure site).

Section 1: Attendee Information

* = required field

Name (first, last, middle initial)*:

Name preferred on conference badge:


Credit Union/League/Organization Name*:

Mailing Address*:

City*:     State*:     Zip*:

CU Telephone*:

CU Fax:

E-mail Address*:

Affiliated with CUNA and your state league?

 Yes (if yes, which league?)
Please note: Affiliation with CUNA/League is required for attendance, but limited exceptions may apply. Please contact CUNA prior to making travel arrangements to confirm eligibility.

Credit union/League individuals: Are you a first-time attendee? Yes No

Please advise us of any disability-related accommodations you may need so proper arrangements may be made at the conference:

In case of emergency, please contact:

Daytime name*:

Daytime phone*:

Evening name*:

Evening phone*:

Volunteer Opportunity

Will you be participating in our volunteer event at the Kipp Renaissance School?
Yes No

Will you be bringing a guest to our volunteer event at the Kipp Renaissance School?
Yes No

Guest Name:

Casino Night

Will you be attending casino night on Monday night (cost is included in registration)?
Yes No

Will you be bringing a guest to casino night?
Yes No

Guest Name:

Section 2: Fees and Payment

Are you a current CUNA Lending Council member? Yes No
Not a member? It pays to Join Now and save up to $250.00 on the conference registration!

Conference Fees

Please select the appropriate fee:
(Note: Members of any CUNA Council may register for the conference at the member rate)

  Registering on or before
October 17, 2011
Registering after
October 17, 2011
Members $799 $899
Non-members $1049 $1149

Please check if you have approval from Council Administration for a complimentary conference registration. Indicate below who you spoke to and explain why you are eligible:

Preconference Workshop Fees

Will you be attending one of the preconference workshops? Yes No
(You must register for the conference to register for the preconference workshop.)

Please select a workshop:
Loan Portfolio Management
The New Benchmarks for Lending

Please select the appropriate fee:

Members $149
Non-members $189


Total amount due: $

Share draft or checks are made payable to: Credit Union National Association.
Or charge $ to my*: VISA MasterCard

Name (as it appears on card)*:

Card account number*:

Expiration date*:

Signature (for print forms) __________________________________________

Refunds will be issued until October 17, 2011, minus a $75 administrative fee. No refunds will be available after this date, but substitutions will be accepted anytime. Non-Member substituting for members will be charged the non-member fee. All cancellations and substitutions must be submitted in writing. For more information call us at (800) 356-9655, ext. 4400.