Oct 27, 2017 - Registration is $60.00 (Make check payable to the Auxiliary Services) There are no registration fees for
201 7
Technology Fall Conference Registration Form
SW
EGO
CTLE #259
IV
ER
SIT
tO
EGO SW tO
N EU
a
S T AT R YO F N E W YO
K
a
October 26 - 27, 2017 • fallconference.com
Name (please print clearly): ________________________________________ Email: ____________________________________ Home Address: _______________________________________________________________________________________ City: __________________________________________ State: ________________________ Zip: _____________________ School/Organization: ___________________________________________________________________________________ Payment Method:
❑ Cash
❑ Check (personal or school)
❑ Purchase Order
Please note: For multiple attendees on one check, each person fills out this form. Registration is $60.00 (Make check payable to the Auxiliary Services) There are no registration fees for full-time students. Lunch in Cooper or Lakeside Dining Hall is included in your registration fee for both Thursday and Friday. Be our Guest at our 78th Celebration Reception/Dinner at the Lake Ontario Event and Conference Center 26 West First Street, Thursday October 26th, 5 - 9 pm. There will be a cash bar. If you are bringing a guest to dinner there will be a charge of $22.00
Would you like to make a contribution to the Department of Technology Endowment Fund? Every contribution makes a difference in the quality of the Technology programs at SUNY Oswego. Technology Endowment Fund Contribution: $ _____________________ Attendee/Conference Information - Please check appropriate response Conference Days: ❑ Thursday Only
❑ Friday Only
❑ Both Thursday and Friday
Mail your PO/check along with this form to: Department of Technology 103 Park Hall SUNY Oswego Oswego, New York 13126
Or Email:
[email protected] Fax: 315-312-3363
Mail no later than October 18 or bring this form and payment to the conference with you.
✁
Tear at perforation.
Office Use Only Below
NYSTEEA annual membership / renewal $50.00 ( $12.00 retired) Total: $ Notes (if any): Please contact Mrs. Teri Davis at 315.312.3011 with payment questions.
R YO F N E W YO
K
a
EGO
SW
SW
tO
SIT
201 7
TE
201 7
ER
ER
SIT
tO
EGO
EGO
SW
a
IV
K
N EU
R YO F N E W YO
IV
SIT
N EU
IV
ER
S T AT
S T AT
N EU
Technology Endowment Fund Contribution: $
Additional Dinner Guest $22.00
LOGY FALL CO N NO F CH
CE EN ER
LOGY FALL CO N NO F CH
❑ I will NOT be attending reception/dinner S T AT
Registration: $60.00
F
CE EN ER
Received From:
CH
CE EN ER
❑ I will be attending reception/dinner
FALL C LOGY Order ❑ Purchase ON NO
tO
❑ Check
TE
Payment: ❑ Cash
TE
78th Annual Fall Technology Conference Registration Receipt 201 7
RK
LOGY FALL CO N NO F CH
CE EN ER
CE EN ER
O WY
TE
ALL C ON F
R YO F N E W YO
K
a
fallconference.com We greatly appreciate your attendance & participation. Please let us know if you have any questions, or if we can be of assistance. Have a great conference!
