NES/MAA Regional Dinner Meetings - Spring 2004

Registration Form for Dinner Meeting at the College of the Holy Cross on March 22, 2004

To use this form, you will need to print it out and mail it. On-line registration and registration through e-mail are NOT available.   Please be sure that you send the registration in by March 12, 2004,  the deadline for this dinner meeting.

To register, send this form with a check for $15.00 per person,  payable to College of the Holy Cross,  to

Name:______________________________________________
 

Institution:__________________________________________
 

Address:____________________________________________
 

   ____________________________________________
 

Telephone:   (W)___________________       (H)_________________
 

E-mail:__________________
 

Choice of entree:     Poached Salmon_____    Chicken Marsala ____    Vegetarian  ______
 


Return to NES/MAA Regional Dinner Meetings - 2004
URL: http://www.southernct.edu/organizations/nesmaa/rdmformholycross2004.html
Revised: February 15, 2004

"The views and opinions expressed in this page are strictly those of the page author and have not been reviewed or approved by Southern Connecticut State University."