ACRL/NY 2005 Symposium
Registration

Name

Library/Organization

Address

City, State, Zip

Telephone

Email

________________________________________________________

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Registration fees, please check one:

$70 ACRL/NY 2005 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
NRR, Frank Melville Jr. Memorial Library
Stony Brook University
Stony Brook, NY 11794
Email: jhclarke@notes.cc.sunysb.edu