NYSAER 2006 CONFERENCE: “Capitalizing on our Future!” Albany, New York
November 5, 6, and 7, 2006
REGISTRATION FORM (please print)
Name: _________________________________________________
Discipline: ______________________________________________ (CVRT, O&M, TVI, other (please specify)
Agency: ________________________________________________
Address: _______________________________________________
_______________________________________________________
Telephone: work ___________________ home ________________
e-mail __________________________________________________
AERBVI Membership Number _______________Exp. _________
(Your membership number must be included to receive a membership rate)
__ No thank you
Choose Concurrent Sessions: Write in the letter of your choice, refer to program.
Sunday, Workshop ______ (Stipend will be available for your Sunday night hotel room)
Monday, Session I _______ Monday, Session II _______
Tuesday, Session III _______ Tuesday, Session IV _______
Your registration must be postmarked by October 15, 2006 to be eligible for the discount.
We do accept walk-ins.
Circle One: (If you would like to donate a door prize or an item for the Auction, please bring it with you to the conference!)
Full Conference: (Sunday – Tuesday) We will be auctioning off a week stay in the beautiful island of Aruba! (donated by Chuck Cohen of C Tech for December 2007. Go to our web site www.nysaer.org for details)
Includes Registration, Sunday workshop, Sunday Reception, Monday Continental Breakfast, Awards Luncheon Buffet, Awards Dinner, Not So Silent Silent Auction, Tuesday Continental Breakfast and Buffet Luncheon.
__Member: $149.00/159.00 __Non-Member: $169.00/179.00 __College Student $129.00/139.00 __Parent $129.00/139.00
Sunday and Monday Only:
Includes Registration, Sunday workshop, Sunday Reception, Monday Continental Breakfast, Coffee Break, Awards Buffet Luncheon. You will need to purchase a Banquet ticket if you plan on attending the Awards Dinner.
___Member: $85.00/95.00 ___Non-Member: $105.00/115.00 ___College Student $65.00/75.00 ___Parent $65.00/75.00
Sunday Only: Licensure Action Workshop and Reception sponsored by NYVRA
___$25.00
Monday Only:
Includes Registration, Monday Continental Breakfast, Coffee Break, Awards Buffet Luncheon. You will need to purchase a Banquet ticket if you plan on attending the Awards Dinner.
__Member: $77.00/87.00 __Non-Member: $97.00/107.00 __College Student $57.00/67.00 __Parent $57.00/67.00
Tuesday Only:
Includes Registration, Tuesday Continental Breakfast, Coffee Break, Buffet Luncheon.
__Member: $65.00/75.00 __Non-Member: $85.00/95.00 __College Student $45.00/55.00 __Parent $45.00/55.00
Albany Marriott: please call the hotel reservation office to make your reservation. Their telephone number is 518-458-8444 or 1-800-443-8952. To ensure conference rates, call and make your reservation before October 15th and be sure to mention you are with “NYSAER”. Rates: single $94.00; double $94.00 ($47.00 per person). The above group rate will be subject to applicable NYS sales and occupancy taxes, unless an individual’s tax exempt certificate is presented at check in. www.albanymarriott.com.
FOR YOUR DINING PLEASURE
Please select one entrée choice for November 6th Awards Dinner and indicate any additional Awards Banquet ticket purchases and entrée selections:
___Chicken Madeira, Herb Crusted Breast of Chicken with Madeira Glaze, Portobello Mushrooms and Roasted Red Peppers
___Sole Chardonnay, With a Crabmeat Filling and topped with fresh Dill Cream Chardonnay
___Kosher Entrée
___Vegetarian Entrée, Grilled Vegetable Lasagna Roulade with Ricotta Cheese, Portobello Mushrooms, Red Pepper and Zucchini
Would you like additional tickets at $35.00 each? Yes, I would like #____ additional tickets.
Additional ticket meal selections: (please write in) ____________________________________________________
Please help us by identifying any access or accommodation you need. We will need this information by October 15, 2006.
REQUEST FOR PROGRAM MEDIA:
____ Print ____ Large Print ____Braille
ADDITIONAL REQUESTS:
____ Tactile Map
____ Hotel Orientation
*Please note any additional individual needs/requests to support your full participation in this conference: _________________
Make checks or money orders in us currency payable to: NYSAER
Amount Enclosed: _$______________
send this registration form with payment to:
Dan McLaughlin
P.O. Box 663
Auburn, New York 13021
If you have any questions please call Suzanne Mullen (315) 635-1768, email: sumullen@aol.com.