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Town Hall, Blue Hill, Maine
November 1, 2002, 8:00 AM - 5:00 PM
REGISTRATION
FORM
| NAME |
: TITLE: |
| ORGANIZATION: |
| MAILING ADDRESS: |
| TOWN: |
STATE: |
ZIP: |
| TELEPHONE: |
FAX: |
EMAIL: |
LUNCH (indicate your menu preference):
Vegetarian____________ Non-Vegetarian___________
WINE AND CHEESE RECEPTION AT MERI:
I will attend _________ I will not attend___________
(MERI is a short walk across the street from Town Hall)
REGISTRATION FEES (Check one):
Registration Without Forum Proceedings: $35.00 _______
Registration With Proceedings: $50.00 _____
Check (Please
make check payable to MERI)_______ Total amount enclosed:______________
Visa_____ MasterCard_____ Card No.___________________________Exp.
Date___________
.
MAIL COMPLETED FORM AND PAYMENT TO:
Jennifer Traub, MERI, PO Box 1652, Blue Hill, ME 04614
REGISTRATION IS LIMITED TO 100. PLEASE
MAIL PAYMENT BY OCTOBER 18, 2002.
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