Joint NYSAVS/MAAVS
CONVENTION AND SHOW
REGISTRATION FORM
October 21- 23, 2010
Please check all that apply (one form per person) :
Exhibitor___ Individual Member___ Life Member___ Board Member___
Commercial Member___ Hon. Life Member___ Judge___
Please Print:
Name ______________________________________Phone ( _______ )______________
Address___________________________________________________
City ______________________ State/Prov. _____________ Zip _______
E-mail address __________________________
Name to go on Badge _________________________________________
In case of emergency, who should be notified:
Name _____________________________ Relationship ________ Phone# ( ___ ) __________
Registration Fees:
NYSAVS/MAAVS Member (by deadline) $25.00................................. ______
Non member (by deadline) $20.00 .......................................... ______
After 10/15, add $10.00 late fee $10.00 .................................. ______
Meals:
Friday dinner (circle one) $24.00 ............................................. ______
__ Broiled Pork Chops
__ Salmon w/Horseradish Crust
__ Vegetarian Entree
Commercial Breakfast (Commercial members) $10.00 ______
Saturday Luncheon $14.00 ............................................. ______
__ Grilled Chicken Sandwich
__ Garden Salad
Saturday Banquet (Circle one)
__ Prime Rib ..............................($26.00) ................................. ________
__ Champagne Chicken............ ($26.00) ................................. ________
__ Vegetarian Entree................. ($26.00) .................................. _______
Total Enclosed ......................................................................... $ ______
Following receipt, you will receive confirmation.
Make checks payable to NYSAVS in U.S. Funds. Send this form (or a
photocopy) with payment to:
Irwin Wagman, 52 Harper Dr., Pittsford, NY,
14534-3104.
Deadline: October 10, 2010 Registrations must be postmarked by the deadline
date to receive the lower registration fee. A $10 service fee will be
imposed on refunds after this date. No refunds after October 18, 2010
Persons with special dietary requirements should make them known when
submitting reservations. Special dietary needs cannot be accommodated after 10/15.