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REGISTRATION FORM |
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Print, complete and mail to: Ms. Selma Salmons Carrier Corporation P.O. Box 4808 Syracuse, New York 13221 |
or fax the form: 315-432-7846 Questions: 315-432-7448 _____ Please check here if you would like a brochure about Boston sent to you. |
Phone Number | Fax Number |
Registration | # of People |
Cost Per Person |
Total Cost |
First Registrant | __________ | x $545.00 | = _________ |
Additional Registrant From Same Company | __________ | x $350.00 | = _________ |
Spouse/Guest Registrant | __________ | x $150.00 | = _________ |
Optional "Cheers" Dinner (Saturday | __________ | x $50.00 | = _________ |
TOTAL AMOUNT ENCLOSED: |
= _________ |
_______ MasterCard | _______ Visa |
Card Number | Expiration Month/Year |
Enclosed Check Number | Total Amount Enclosed |
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