Intercollegiate Broadcasting System (IBS)
367 Windsor Highway
New Windsor, NY 12553-7900
(Tax ID: 23-705-9805)Phone: 845 565-0003
FAX: 845-565-7446
email: IBSHQ@aol.com________________________________________Please...
Print this form, fill it in and mail with your payment check.
Registration is $25 per person, including breakfast, lunch and sessions
Your registration is not confirmed until we receive your check.Mail to: IBS, 367 Windsor Highway, New Windsor, NY 12553
(IBS Federal ID for your business office is: 23-705-9805)Station Call Letters:____________________
School Name:__________________________
Station Phone: ______ _______________
Station FAX: ______ _______________
Station email address: _____________________
Station mailing address: _________________________
City: ______________________
State: ________ Zip: _________
Registration fee:
IBS member stations, IBS Professional Associates and High School Students:
___ $25/person
Non-member stations:
___ $45/person
Our payment check for ___ people in the amount of $__________
is enclosed or has been, or will be,
Mail to: IBS, 367 Windsor Highway, New Windsor, NY 12553Please register the following people (please print clearly):
Person #1
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #2
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #3
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #4
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #5
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #6
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #7
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #8
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #9
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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Person #10
First Name:_________________ Last Name: ___________________
Person's Station Job Title for Badge: _________________________
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