2008 CAROUSEL CONFERENCE

Elmira, New York

Registration Form

PLEASE PRINT

Name: ________________________________________________________________

Address: ______________________________________________________________

_______________________________________________________________

Daytime Phone: ____________________Evening Phone: __________________

E-mail Address: _______________________________________________________

• *Early Registration Fee $90.00 x _____ = $________

(MUST be received by March 1, 2008)

• Registration Fee $95.00 x _____ = $________

· T-Shirt $12.00 x _____ = $________

Small _____ Medium _____ Large _____ X-large _____ 2XL (+$3) _____ 3XL (+$3) _____

HURRY!!!! For Hotel Reservations: Hilton Garden Inn (607) 795-1111

Limited number of rooms due to other conferences and college graduations

Registration fee reflects cost per person… including lectures, scheduled events and several meals

*Hotel and transportation costs are extra

REGISTRATIONS DUE BY APRIL 1, 2008

*Early registration discount if received by March 1, 2008

If you have any questions… please contact:

Mary Ann Gordon-EPCPS General Manager

RGORDON3@stny.rr.com

(607) 796-9772

Mail this form and check (payable to EPCPS) to: EPCPS PO Box 3056 Elmira, N.Y. 14905

For event updates visit www.eldridgepark.us/conference