PACNY



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Conference Registration Form - Deadline Wed. Feb. 24 All Payment Must be Made Via Fax, Mail or Phone
Conference Pre-Registration by February 24 $210 for one reservation, both days $160 per person for two or more persons, both days $120 per person for one day only $ 25 additional fee per person, per day for walk in registrants	Room Reservations by February 5 $107.00 per night + tax & gratuity, regular rate $70.00 per night + tax & gratuity, w/gov’t voucher at the Inn at Turning Stone For Room Reservations Call (800) 771-7711

No. of People Attending Wednesday Night's President's Reception Attendee 1 Name: Both Days Thurs. Only Fri. Only Amount Attendee 2 Name: Both Days Thurs. Only Fri. Only Amount Attendee 3 Name: Both Days Thurs. Only Fri. Only Amount Attendee 4 Name: Both Days Thurs. Only Fri. Only Amount Total Contact Organization Address City, State Zip Telephone: Fax Email Check Charge Mastercard Visa AmEx (We Need Card No., Exp Date, Printed Name and Signature in Writing) ** Please fax payment information, or mail payment information to: PACNY, PO Box 3148, Syracuse, NY 13220 Tel: (315) 466-3150 Fax: (315) 437-1440
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