CSRT 65th Annual Conference Registration Form
(Make all checks payable to the CSRT)

Name_______________________________________________

Address_____________________________________________

City___________________________  State______  Zip_______

E-Mail______________________________________________

We will confirm via e-mail.

______________ CSRT Members Fri only  $15.00

______________ Non CSRT Members Fri only  $25.00 (does not include membership)

______________ CSRT Members Sat only  $120.00 (includes Lunch Sat)

______________ CSRT Members Fri and Sat  $130.00 (includes Lunch Sat)

 

______________ CSRT Students Fri only  $15.00

______________ CSRT Students Sat only  $50.00 (includes Lunch Sat)

______________ CSRT Students Fri and Sat  $60.00 (includes Lunch Sat)

______________ Non CSRT Members ADD $25.00 to above prices.

______________ Non CSRT Students ADD $10.00 to above prices.

 

Pre-Registration ends September 1, 2007.
Include copy of your CSRT Membership Card with registration.

There will be an additional $20.00 fee assessed for on-site registration.
Lunch can not be guaranteed for those not pre-registered.

Mail to:
Alicia Giaimo, CSRT Membership Chairman
44 Marion Drive
North Haven, CT 06473

______ Check here for vegetarian lunch. There will be a $20.00 on site registration fee assessed. Lunch cannot be guaranteed for on-site registrations.
PLEASE RESPOND BY SEPTEMBER 7, 2007