April 14th – April 16th, 2023Embassay Suites, 225 Shorecrest Drive, Altamonte Springs, FL 32701 FLORIDA DISTRICT CONVENTION REGISTRATION 2023 "*" indicates required fields A registration form must be submitted for each person registering. Make checks payable to and mail to: Florida District, Pilot International Missy Ridgway, Treasurer 79 Pecan Pass • Ocala, FL 34472 Registration must be postmarked by March 23, 2023 to avoid a late fee of $20.00. Registration fee refunds will be considered by the DAC in cases of illness or other unavoidable circumstances. Written requests giving reasons may be made to the District Treasurer within five days prior to the first day of convention. If a request is made after convention, refunds may be made at the discretion of the DAC only if received within 30 days of the close of convention. An administrative fee of $25.00 will be charged on all canceled registrations. Registration will open at 3:00 pm on April 14, 2023. Number of RegistrationsOne AttendeeTwo AttendeesThree AttendeesParticipant InformationRegistration* Full Registration Includes: Saturday Lunch & Banquet and registration materials ($125.00) Full Registration (Anchors, Compass and PSHF Residents ONLY) Includes: Saturday Lunch & Banquet and registration materials ($125.00) Partial Registration includes Saturday Lunch and registration materials ($65.00) Saturday Night Banquet Ticket ($65.00 ) Please check one:* Pilot Co-Pilot Anchor Compass PSHF Guest Past Governor Delegate Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Pilot Club* Email* Emergency Contact* First Last Emergency Contact Phone*First Time Attending Convention Yes No Are You A Club Delegate Yes No Saturday Lunch Ham Sandwich Turkey Sandwich Veggie Wrap Includes chips, dessert & drinkSaturday Night Banquet Prime Rib, Roasted Potatoes, Seasonal Vegetables Vegetarian Farfalle with Mushroom Rose Sauce Includes salad, bread & dessertList Food Allergy or Dietary Restrictions (Not Dislikes):Second Registration InformationRegistration* Full Registration Includes: Saturday Lunch & Banquet and registration materials ($125.00) Full Registration (Anchors, Compass and PSHF Residents ONLY) Includes: Saturday Lunch & Banquet and registration materials ($125.00) Partial Registration includes Saturday Lunch and registration materials ($65.00) Saturday Night Banquet Ticket ($65.00) Please check one:* Pilot Co-Pilot Anchor Compass PSHF Guest Past Governor Delegate Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Pilot Club* First Time Attending Convention Yes No Are You A Club Delegate Yes No Saturday Lunch Ham Sandwich Turkey Sandwich Veggie Wrap Includes chips, dessert & drinkSaturday Night Banquet Prime Rib, Roasted Potatoes, Seasonal Vegetables Vegetarian Farfalle with Mushroom Rose Sauce Includes salad, bread & dessertList Food Allergy or Dietary Restrictions (Not Dislikes):Third Registration InformationRegistration* Full Registration Includes: Saturday Lunch & Banquet and registration materials ($125.00) Full Registration (Anchors, Compass and PSHF Residents ONLY) Includes: Saturday Lunch & Banquet and registration materials ($125.00) Partial Registration includes Saturday Lunch and registration materials ($65.00) Saturday Night Banquet Ticket ($65.00) Please check one:* Pilot Co-Pilot Anchor Compass PSHF Guest Past Governor Delegate Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Pilot Club* First Time Attending Convention Yes No Are You A Club Delegate Yes No Saturday Lunch Ham Sandwich Turkey Sandwich Veggie Wrap Includes chips, dessert & drinkSaturday Night Banquet Prime Rib, Roasted Potatoes, Seasonal Vegetables Vegetarian Farfalle with Mushroom Rose Sauce Includes salad, bread & dessertList Food Allergy or Dietary Restrictions (Not Dislikes):Complete Your RegistrationOnline Registration Fee Price: Total EmailThis field is for validation purposes and should be left unchanged.