ACRL/NY 2006 Symposium
Registration

Name

Library/Organization

Address

City, State, Zip

Telephone

Email

________________________________________________________

________________________________________________________

________________________________________________________

________________________________________________________

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Registration fees, please check one:

$70 ACRL/NY 2006 member (new and returning members pay this rate)
$80 Non-member
$30 Library school student or retiree

Contact me about serving on next year's Symposium Committee

I would like to contribute $________to the ACRL/NY Distinguished Service Memorial
    Award Fund

Make checks payable to ACRL/NY & mail with this form to:

Janet H. Clarke
Stony Brook University Libraries
Melville Library, N-1001
Stony Brook, NY 11794-3301

Email: jhclarke@notes.cc.sunysb.edu