REGISTRATION FORM
2008 NFIP Claims Presentations


PLEASE TYPE OR PRINT CLEARLY

Use this form to reserve a seat in the presentation of your choice. Choose only one!

	
Presentation Number 		  Location _____________ ____

Your Name 											

Your Flood Certification Number (if applicable) ____________________________  _  
					
Your Street Address 									

City 	______	

State 		  ZIP Code				

Daytime Telephone Number 	_____	      ___

When you have completed this Registration Form, mail it with your $10.00 check or money order to:


               Claims Presentation Coordinator 
                NFIP Bureau & Statistical Agent
	  7700 Hubble Drive
                Rm. N195
                Lanham, MD  20706


Make your check or money order payable to the National Flood Insurance Program.  Cash will not be accepted.
        

For more information, call 800-426-6347 ext. 1746


PLEASE DO NOT FAX THIS FORM