To register for the Regional Aquatics Workshop (RAW), please print this form, complete it and mail it
with payment to
the following address:
Joe Yaiullo
RAW 2008 Conference Registration
Atlantis Marine
World
431 East Main St
Riverhead, NY
11901
Or fax registration form with credit card info to: Loretta Greif at 631-208-0466.
Email: lgreiff@amwny.com to verify secure transmission of information.
Full Name:
Name as it should appear on badge:
Institutional or
business affiliation:
Address:
City:
State:
Zip/Postal Code:
Country:
E-mail:
Telephone:
Fax:
RAW
Conference
Before May 1st, 2008
(fee per person)
____$50 Public Aquarium or Non-profit affiliate
____$150 Commercial Affiliate
____Waived – Third tier sponsor
After
May 1st, 2008
(fee per person)
____$75 Public Aquarium or Non-profit affiliate
____$185 Commercial Affiliate
____Waived – Third tier sponsor |
Indicate if you will be attending:
___AZA
TAG Meetings (Jun 16)
___General sessions (Jun 17-19)
___Wine & Cheese (Jun 16 evening)
___Cocktail Hour and Dinner (Jun 17 evening)
___Olympics and BBQ (Jun 19 PM)
|
Form
of payment:
____Check (make checks payable to:
Atlantis Marine World)
____Credit Card (circle one):
Visa Mastercard
American Express
Discover
Print name as it appears on the card:
Credit Card Number:
Expiration Date:
Signature: |
Registration fee
covers meeting materials, program, breaks, evening events, bus trips.
Please use one
form per attendee.
Deadline for
early registration is May 1st, 2008.
No cash please.