NYSMATYC Annual Conference - April 12-14, 2002
Holiday Inn Arena, Binghamton, NY

Registration Form

You must be a current member of NYSMATYC to register for this conference. If you aren't, you'll need to include an additional $15 for dues for the 2002 calendar year.

A. NYSMATYC MEMBERSHIP INFORMATION:

Name _____________________________________________________________

• I am a NYSMATYC member for the 2002 calendar year.
• I am not a NYSMATYC member for 2002. (add $15 membership fee) $ ___________

B. PERSONAL INFORMATION (required for nonmembers only):

College or affiliation __________________________________________________

Address ____________________________________________________________

Email ______________________________________________________________

C. REGISTRATION INFORMATION - early registration fees must be received by April 1, 2002.

• Registration fee ($30 before April 1, $35 after) $ ___________
• Presenter fee ($20 before April 1, $25 after) $ ___________
• Student fee ($5 - membership not required) $ ___________

Check one if appropriate:      O presenter        O presider

Name to be printed on name tag ___________________________________

Name of guest __________________________________

D. TOTAL Amount Due $ ___________

Please send this completed sheet, along with a check made payable to "NYSMATYC", to:

Johanna Halsey, NYSMATYC Treasurer, Dutchess Community College, 53 Pendell Road, Poughkeepsie, NY 12601