REGISTRATION FORM

JPC SPEAKERS DAY - SATURDAY NOVEMBER 2, 2002

NAME _____________________________PHONE No. _________________E-mail __________________

ADDRESS__________________________CITY___________________STATE________ZIP ___________

Enclosed is my check for ____ registration(s) @ $35.00 each. Checks must be made payable to JOINT PRESIDENTS COUNCIL and mail to Joe Reider, Jr., 94-62 217th Street, Queens Village, NY 11428.   Telephone (after 7 p.m. only) 718-776-0929.

YOUR CHECK IS YOUR RECEIPT. THERE ARE NO REFUNDS

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