Technology Fall Conference Registration Form

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Technology Fall Conference Registration Form

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October 26 - 27, 2017 • fallconference.com

Name (please print clearly): ________________________________________ Email: ____________________________________ Home Address: _______________________________________________________________________________________ City: __________________________________________ State: ________________________ Zip: _____________________ School/Organization: ___________________________________________________________________________________ Payment Method:

❑ Cash

❑ Check (personal or school)

❑ Purchase Order

Please note: For multiple attendees on one check, each person fills out this form. Registration is $60.00 (Make check payable to the Auxiliary Services) There are no registration fees for full-time students. Lunch in Cooper or Lakeside Dining Hall is included in your registration fee for both Thursday and Friday. Be our Guest at our 78th Celebration Reception/Dinner at the Lake Ontario Event and Conference Center 26 West First Street, Thursday October 26th, 5 - 9 pm. There will be a cash bar. If you are bringing a guest to dinner there will be a charge of $22.00

Would you like to make a contribution to the Department of Technology Endowment Fund? Every contribution makes a difference in the quality of the Technology programs at SUNY Oswego. Technology Endowment Fund Contribution: $ _____________________ Attendee/Conference Information - Please check appropriate response Conference Days: ❑ Thursday Only

❑ Friday Only

❑ Both Thursday and Friday

Mail your PO/check along with this form to: Department of Technology 103 Park Hall SUNY Oswego Oswego, New York 13126

Or Email: [email protected] Fax: 315-312-3363

Mail no later than October 18 or bring this form and payment to the conference with you.

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Office Use Only Below

NYSTEEA annual membership / renewal $50.00 ( $12.00 retired) Total: $ Notes (if any): Please contact Mrs. Teri Davis at 315.312.3011 with payment questions.

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Technology Endowment Fund Contribution: $

Additional Dinner Guest $22.00

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Registration: $60.00

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Payment: ❑ Cash

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78th Annual Fall Technology Conference Registration Receipt 201 7

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fallconference.com We greatly appreciate your attendance & participation. Please let us know if you have any questions, or if we can be of assistance. Have a great conference!