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Registration

Registration Form

Written by Administrator

Tuesday, 27 June 2006

Click here for On-Line Registraion 
 
 
NEW YORK USITT REGISTRATION FORM
  *Please print

     NAME

     ADDRESS

     HOME PHONE NUMBER

     CELL PHONE NUMBER

     FAX NUMBER

E      MAIL ADDRESS

     WEB SITE ADDRESS

     Are you a member of the National USITT?      Yes.   No.

     Member #

  
  REGISTRATION LEVEL    Circle One

     Individual Memberships

     Corporate Membership

     STUDENT

$10

     INDIVIDUAL

$25

     PROFESSIONAL

$50

     JOINT PROFESSIONAL

$75

     NOT FOR PROFIT

$75

     SUSTAINING

     $100

     SUSTAINING

     $150

     CONTRIBUTING

     $200

     CONTRIBUTING

     $300

     FOUNDER

     $500

     FOUNDER

     $1000

Make check payable to

USITT NYAS

Mail to:

USITT NY Area Section

PO Box 1016

Peck Slip Station

Last Updated ( Monday, 16 April 2007 )

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