REGISTRATION

Contact Information
  First name   Last name  
     
  Preferred title   Institution  
     
  Postal Address line 1   Email address  
     
  Postal Address Line 2   Email Address (confirm)  
     
  City   State, Zip  
     
  Daytime Telephone number      
       
         
 
NERALLT Membership -- Optional
  Renew Current Membership
$25.00    
  Join NERALLT
$25.00    
           
 
Meeting Registration
  Fall Meeting Fee
$25.00  
  Fall Meeting Fee (students)
$7.50  
  [Meeting fee includes light breakfast and full catered luncheon and is waived for presenters]  
  COUNT ME IN!

Informal group dinner Thurs. evening (self-pay) Headcount for restaurant reservations.

 
Payment Remittance
Your total due: $       
         
         

We appreciate advance payment by mail, either by check or money order.

Deadline for mail payment is Friday, October 19, 2007. You may also pay at the door (checks or money orders preferred). We will provide receipts for each transaction.

Please mail to:

Mary Morrisard-Larkin
College of the Holy Cross
1 College St., Box 118A
Worcester, MA 01610

Make checks payable to NERALLT.

      
Please print out a copy of this page and enclose it with your check so that we will apply your payment correctly.