Please print this page (or this Word document), fill it out, and send it (with payment, if not a student).
If you are a student,
the conference is free,
Phone(s): Home: ___________________ Work: ____________________ Cell: ______________________
Student? [__] yes [__] No
Any special needs? _______________________________________________________________________
Send this form (and payment) to Donn Weinholtz (860-768-4186, email@example.com)