NFSPS Registration Form (Detailed)

Discover the Treasure - Poetry's Place in the Sun
The Florida State Poets Association
presents
The National Federation of State Poetry Societies Annual Convention
June 24 through 29, 2015 at the Hilton St. Petersburg Bayfront Hotel
333 1st Street South, Saint Petersburg, FL 33701-4342
For Hotel Reservations go to:
http://www.hilton.com/en/hi/groups/personalized/S/SPTSHHF-FSP-20150624/index.jhtml?WT.mc_id=POG
Special Room Rates with 2 Double Beds or 1 King Bed
rates from 119.00 USD/Night
Accommodation Dates: June 24, 2015 - June 29,2015
Book by May 25th to reserve your room
Phone Number: (800) 445-8667
NFSPS Convention Registration: Please complete one form for each attendee.
Please submit Registration by May 25, 2015
(Please make a copy of your completed form to keep for your own records)
Name______________________________________________________
Address ____________________________________________________
Phone ________________________ Email _________________________________________
Will you require any particular accommodations (please indicate by marking X)
_______ none required
_______ ASL Sign Language Interpreter
_______ Lift-equipped ground transportation
_______ Other - Please specify _______________________________
Registration Fee Schedule
Total
Participant ............................ ______ @ $75 ......... _______________
Student................................... ______ @ $25 ......... _______________
Guest (not participant) .......... ______ @ $25 ......... _______________
Registration Total _______________
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Detailed Menu for Meals* Please please place an “X” on the line before each option to indicate your choice for each meal
and then enter the number, prices, and totals in the chart on the following page.
Friday lunch: _____Florida Cobb Salad w/diced grilled chicken breast, green salad mix, tomatoes, chopped eggs,
gorgonzola cheese, bacon bits, shredded cheddar cheese, mandarin oranges, house dressing; includes rolls and butter,
coffee, iced tea
or
_____The Jannus Sandwich: Sliced oven roasted turkey with Swiss Cheese, mayonnaise, lettuce, tomato, served on flaky
croissant, includes coffee, iced tea
or
_____Vegetarian option
Friday Dinner: _____London Broil Marsala-marinated grilled flank steak served with mushroom marsala sauce, includes
salad, vegetables, one side, rolls, butter, beverage, dessert
or
_____Vegetable Moussaka: layers of zucchini, yellow squash, red peppers and eggplant topped with Feta and Parmesan
Cheese and artichoke pomodoro sauce, salad, rolls, butter, beverage, dessert
or
_____Vegetarian option
Saturday lunch: _____Caribbean Island Salad w grilled Jamaican Jerk chicken breast, romaine lettuce, shredded
parmesan cheese, banana nut croutons and mango caesar dressing, beverage, rolls and butter or
or
_____The Al Lang Sandwich: Sliced Ham and turkey with smoked bacon, cheddar cheese, lettuce, tomato, rolled in a red
pepper flour tortilla, includes coffee, iced tea;
or
_____Vegetarian option
Saturday Dinner: _____ Chicken Piccata-sauteed chicken breast topped with capers and citrus wine glaze, salad,
vegetables, one side, rolls, butter, beverage, dessert
or
_____Vegetable Pasta: assorted vegetables served with penne pasta and a roasted garlic sauce, salad, rolls, butter,
beverage, dessert
Sunday lunch: _____Asian Chicken Salad w/ asian marinated chicken with asian cabbage salad, julienne snow peas,
bean sprouts, carrots, and orange teriyaki dressing, includes rolls, butter, coffee, iced tea
or
_____The Whitted Sandwich: sliced tenderloin of beef with herbed boursin cheese spread, sliced red onions, lettuce and
tomato, served on rosemary foccacia bread, includes coffee, iced tea
or
_____Vegetarian option
Sunday Dinner: Caribbean Mahi-Mahi - grilled mahi-mahi seasoned with Jerk spices and topped with a banana-mango
sauce, salad, vegetables, one side, rolls, butter. beverage, dessert
or
Vegetable Strudel- sauteed red and green peppers, egg plant, zucchini squash and portobello mushrooms mixed with
parmesan cheese rolled in puff pastry and baked golden brown, served with balsamic reduction, salad, rolls, butter,
beverage, dessert
* I need a special diet; please list particular requirements (e.g. gluten-free, sugar-free, lactose-free; be specific:
_________________________________________________________________________________________
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Meals
Friday lunch
Friday dinner
Saturday lunch
Saturday dinner
Sunday lunch
Sunday dinner
6-Meal Package
Cost
Total
$28.50
$42.50
$28.50
$42.50
$28.50
$42.50
$198.00 (discounted pricing)
Meal Total
Optional Group Activities:
Thursday, June 25, 2015; 9 AM to 3 PM
Choose One (X on the line to choose that activity)
______ 1) Travel to Sarasota to visit the beautiful Bayside Gardens and Grounds of the Ringling Compound with
historic owner's villa, the Ringling Circus Museum, and the Classic Fine Art Gallery. Lunch may be purchased on the
grounds at the Treviso Restaurant or the Banyan Café.
$45.00 per person for transportation and entrance fees)
20 person minimum.
______ 2) Visit Old Towne Tampa. See historic Ybor City founded by Vicente Martinez-Ybor as a cigar manufacturing
center, today is one of only two National Historic Landmark Districts in Florida; the Photography Museum, Fine Arts
Gallery, Scenic Riverwalk, and the flamboyant Moorish buildings of the University of Tampa's historic campus. Lunch
for purchase at the Columbia Restaurant, the oldest restaurant in Florida (founded in 1905 by Casimiro Hernandez, Sr. and
in 2010 named one of only 50 in the U.S. as an All-American Icon.
$50.00 per person for transportation and entrance fees)
20 person minimum.
______ 3) Take an unforgettable trip to beautiful St. Pete Beach for beachcombing, shell collecting, sunning, and
swimming in the warm, inviting waters of the Gulf of Mexico. The award-winning white sand beach will invite you to
relax and kick-back. While at St. Pete Beach, enjoy The Pier, a five-story dining and shopping complex. Lunch on your
own at the beach.
$25.00 per person charge for transportation
10 person minimum
All tours start at 9:00 AM and return to hotel by 3:00 PM
Name of Participant: _____________________________
Total for Thursday Activity Charge $ ____________
Sunday, June 27, 2015, 2:30 PM - 4:30 PM
Dali Museum and Surrealism Poetry Workshop
~ presented by Florida State Poets Association and the Dali Museum
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An exciting afternoon at the world famous Dali Museum for Surrealist poetry writing with Paris-born surrealist
author and poet Dan Pels and celebrated poet, author, and teacher Melanie Hubbard.
Museum admission includes a Special Exhibit (February 20 - August 30) of drawing, collage, watercolor,
acrylic, mixed media, digital photography; Student Surrealist Art Exhibits 2015: Psyched Out: Reinvented
Myths
(The Dali Museum is across the street from the hotel so no extra transportation is required. Please X on
line for admission to the Dali Museum.)
______ $20.00 - Discounted Ticket includes admission to the Museum, the Galleries, the Exhibits, the audio
self-guide tour, the poetry workshop
Convention Fee Summary:
Registration ......................$______________
Meals ................................$______________
Thursday Activity Trip .... $______________
Dali Museum ....................$______________
Grand Total .......................................................................$______________
Make checks payable to Florida State Poets Association, Inc.
Send check and registration to:
Judith Krum, FSPA Treasurer/Convention Registrar
2614 S. Marshall Ave.
Sanford, FL 32773
Questions: Judith Krum, email: judithkrum@att.net; cell phone: 386-624-3402
Per Diem Ticket Admission to workshops and speakers (no meals):
$25.00/ payable at registration desk
Airport to Hotel Shuttle Service for NFSPS Convention June 24 - 29, 2015; From the Tampa Airport to
the Hilton St. Petersburg Bayfront Hotel
_____________________________________________________________________________
Super Shuttle - Phone (800) 258-3826
 For a one-way trip for one passenger: $25.00; two passengers: $48.00; three passengers: $71.00
 Credit card needed for reserving a reservation when passenger calls
 Reservations appreciated; they will ask for your flight information (airline, flight number, date, time of
arrival, etc.) when you make your shuttle reservation.
 Prices listed are all-inclusive, no extra for tax or luggage
Shuttle service has a lift-equipped vehicle for someone using a wheelchair; need 48 hours advance notice for the
lift-equipped vehicle.
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