NJAC Meeting Registration Form

Name: _______________________________________________________

Address: _____________________________________________________

Telephone: ____________________________________________________

# of Guests ($20/person): ________________________________________

Interested in:

Skiing (for group rate) YES NO

Hotel (for group rate) YES NO

Carpooling YES NO

*Registration Deadline - February 15, 2008; First come, first serve basis*
**Visit www.njcytology.com for more info

Mail Form with Check payable to NJAC:

New Jersey Association of Cytology
P.O. Box 1556
South Hackensack, NJ 07606