REGISTRATION FORM

Name:_____________________________________________________________________
 

Name for Nametag:___________________________________________________________
 

Affiliation:___________________________________________________________________
 

Street Address:______________________________________________________________
 

City:_______________________________________________________________________
 

State/Country:_____________________________ Postal/Zip Code:____________________
 

Telephone:_______________________________ Fax:______________________________
 

Email:_____________________________________________________________________
 

Registration Fee: (please circle the appropriate fee enclosed)

  • $100 (before December 1st, 1998)

    •  
  • $150 (after December 1st, 1998)
On Saturday, will you (please indicate one):

___Take the bus to JFK airport

___Stay for lunch and short afternoon program (until 3:30 p.m.)

___Neither; will be departing 1:00 p.m. or earlier.
 

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