Metro NY District 2004 Annual Meeting

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Online Registration Form

On or before April 23, you may register online if you are paying for your registration with a credit card. Just fill out the form below and click SUBMIT. If you prefer to pay by check or to register through the mail, click here. Mailed registration forms must be postmarked by April 21. Otherwise you must register at the meeting and pay an additional $10. For those registering at the meeting, only checks or credit card payment will be accepted.
 
Name:
Address:
City:
State:
Zip:
Email:
Phone:
Congregation:
Special Needs:   Describe any special assistance you need to participate, including home hospitality and childcare. Please return your registration form by April 16.

Workshops:

Help us plan space needs by indicating your first and second choice. Doing so does not commit you to either workshop.

First Choice

  

Second Choice
 
Registering for:  
Credit Card Payment: You must pay by credit card to register online.
Type of Card:
Account Number:
Expiration Date:
Name on Account:
Address of Account Holder:
Street:
City:
State:
Zip: