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Air Care 2004 Conference Registration Form Please Register the Following Persons to attend AIR CARE 2004 April 30 -
May 1: 1) Y N Y N 2) Y N Y N 3) Y N Y N 4) Y N Y N 5)
Y
N
Y
N Form completed by: __________________________________________ Phone Number__________________________ Group__________________________ Email address_________________________________ Number at conference ___ x $35 = _____ plus No. at Friday dinner ___ x $30 =_____ Total remitted: $____________ by mailed check #_________ or check this box if bringing your check to the conference ______ NOTE: Payment by check is preferred and can be mailed to us or brought with you to the conference. Signed ________________________________________________________ FAX COMPLETED FORM TO: 603-806-7937 BY Fax deadline April
27, 2004
AIR CARE 2004 Registrar AFTER THOSE DATES
call us at (770) 452-7958 ext 3, fax us at 603-806-7937
, or See the bottom of our conference page for hotel information - www.aircareall.org/aircare2004.htm Questions? Send them to conference@aircareall.org |
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