ATTENDEE REGISTRATION FORM
3 Ways to Register
May 22-25, 2010 - McCormick Place - Chicago, IL USA
www.restaurant.org/show
Step 1 Contact Information
FIRST NAME (as you would like it to appear on badge)
PROFESSIONAL TITLE COMPANY NAME ADDRESS
STATE/PROVINCE PHONE EMAIL
LAST NAME
Advance Registration Deadline: April 16, 2010
Online registration will remain open through May 24, 2010.
Mail to: NRA Registration Headquarters P.O. Box 624, Brookfield, IL 60513-0624
(708) 344-4444 Fax:
PLEASE PRINT CLEARLY and complete all fields. The Show is for trade only and not open to the public. Badges mail individually unless requested otherwise. Badges will begin mailing in April.
___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________
CITY
POSTAL CODE FAX
COMPANY WEBSITE
Are you at least 21 years of age? Yes No
Step 2 Industry Classification
If not 21, are you at least 16 years of age?
Yes No
Restaurant/Foodservice/Retail
What term BEST describes your establishment or operation?
Restaurant/Foodservice Commercial
1 Table Service - Fine Dining 2 Table Service - Casual Dining 3 Table Service - Family Dining 4 Quick Service 5 Fast Casual 6 Pizza 7 Bar/Tavern/Pub/Brewery 8 Coffee Shop/Donut/Bakery/Chocolatier 9 Ice Cream/Frozen Novelty 10 Buffet/Cafeteria/Banquets 11 Catering - On/Off Premise 12 Clubs - Social/Country/Golf 13 Concessions - Theme Parks/Sports/Entertainment 14 Conference/Convention Centers 15 Mobile Foodservice & Vending 16 Airlines/Commissary 17 Lodging/Casino/Cruise Ship 18 Other _______________________
Restaurant/Foodservice Non-Commercial
19 Business & Industry/Other Contract Foodservice 20 College/University Foodservice 21 Correctional Institution/Prison 22 Health Care/Retirement 23 Military/Military Clubs 24 School Foodservice
Retail
25 Convenience Store 26 Specialty Store/Gourmet/Deli 27 Supermarket 28 Wholesaler/Warehouse Club
What BEST describes your ownership?
(Check only one)
29 Chain-owned 30 Franchise/Independent 31 Independent
32 Multi-unit Headquarters 33 Non-commercial
Step 3 Payment Information
Full payment MUST accompany this form. A confirmation will be sent approximately 72 hours after receipt of form if an email address is provided. By registering, you give us permission to provide your contact information to our exhibitors. If you desire otherwise, you must contact us in writing. Refunds will be given on all cancellations received in writing by April 16, 2010.
$40
per person if received by April 16, 2010
$80
per person after April 16, 2010
Lodging Dealer/Distributor
Restaurant/Foodservice/Retail
Do you serve alcoholic beverages?
(Check only one)
34 Yes 35 No
36 How many units do you represent? _____
What are the annual sales at your
operation? (Check only one)
37 Under $100,000 38 $100,000 - $499,999 39 $500,000 - $1,499,999 40 $1,500,000 - $4,999,999 41 $5,000,000 - $24,999,999 42 Over $25,000,000
What is your purchasing role?
(Check only one)
43 Make decisions 44 Specify products/ services
45 Influence decisions 46 No role
What is your PRIMARY job function?
(Check only one)
47 Corporate/Executive Management 48 Owner 49 Operations 50 Chef/Executive Chef 51 FOH Management 52 Beverage Management 53 Purchasing/Distribution 54 Accounting/Finance 55 MIS/IT 56 Marketing/Sales 57 Training/HR 58 Nutrition/Dietetics 59 QA/R&D 60 Design/Construction 61 Other _______________________
Check Enclosed
Made payable to: National Restaurant Association
American Express Diners Club Discover MasterCard Visa
Card Number Cardholder Name Authorized Signature
nraregistration@restaurant.org
Enregistrez-vous aujourd’hui sur www.restaurant.org/show!
Expiration Date
Have you attended NRA Show in the past? Yes No
Check one box that best represents you and answer the corresponding questions below.
Supplier
Affiliated
Lodging
What term describes your lodging operation?
L1 Bed & Breakfast L2 Casino L3 Cruise Ship L4 Hotel L5 Motel L6 Resort/Spa
Number of rooms at your lodging location?
(Check only one)
L7 Under 50 L8 50-150 L9 Over 150
What is your PRIMARY
job function?
(Check only one)
L10 Corporate L11 Front Desk L12 General Manager L13 Operations L14 Owner L15 Purchasing L16 Sales/Catering L17 Other _________________
Chef (please register under Restaurant/Foodservice)
What is your purchasing role?
(Check only one)
L18 Make decisions L19 Specify products/services L20 Influence decision L21 No role
Dealer/Distributor
D1 Beverage Alcohol Distributor D2 Beverage Wholesaler D3 Equipment Dealer D4 Food/Beverage Broker D5 Food Distributor D6 Supplies Distributor
Buying Group Affiliation:
____________________________________ Trade Association Membership: ____________________________________
Affiliated
A1 Advertising/PR/Publications A2 Architect/Designer A3 College Student - Culinary/Hospitality A4 Consultant A5 Equipment Service A6 Exporter/Importer A7 Faculty/Admin/Training A8 Financial Services A9 Government Agency/Utilities A10 Information Technology A11 Manufacturers Agent/Rep A12 Specifier A13 Trade Association A14 Guest A15 Other __________________
Supplier
S1 Beverage Manufacturer S2 Equipment Manufacturer S3 Food/Ingredient Manufacturer S4 Supplies Manufacturer
FR
COUNTRY
No one under age 16 (including infants and toddlers) will be admitted.
You must provide
your business’ tax ID number or attach a business card here
Tax ID Number
EN
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