Please use a separate form for each attendee.
| Name: | __________________________________________________ |
| Library: | __________________________________________________ |
| Address: | __________________________________________________ |
| Phone: | __________________________________________________ |
| FAX: | __________________________________________________ |
| E-mail: | __________________________________________________ |
| Amount Enclosed | |
| Registration Fee (includes breaks and parking fee): $20 | $ |
| Buffet Lunch: $ 7 | $ |
| Total enclosed: | $ |