ACBNY 2020 Legislative Registration - Check

Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number
Email
Saturday arrival time:
And train number:
Room rate is $84 per night. Mark each night you will be staying below:

Room rate is $84 per night. Mark each night you will be staying below: Saturday Sunday
My Roommate(s) are:
Registration Fee

Registration Fee $20 Payable by all attendees
Lunch: $22 includes
Vegetable soup, Saratoga chips, dessert, soft drinks, tea or coffee.
Lunch Choice:

Lunch Choice: Grilled Ham and Swiss Flat-bread Pizza Chef Salad Philly Stake & Cheese Salad Platter
Sponsorship donation, Thank you! $ Dollars . Cents
Total = Rooms * $84 + $20 (Registration fee) + $22 Lunch + Sponsorship

Thank you, please make your payment payable to ACBNY send it to:
Mike Golfo
c/o ACBNY
1403 Chadwick Court
Tarrytown, NY 10591

If you have questions please call Meghan Parker 914-417-8651, or emailmparker@ilny.org
$0

Total