NY Metro ASHI

The Founding Chapter

                                                                         

 

 

Seminar Registration Confirmation


Dear First_Name MI Last_Name,

You have successfully registered for the 2011 NY Metro Seminar!  The following is the information you entered:

First Name: First_Name
Middle Initial: MI
Last Name: Last_Name
Title: Title
Company: Company
Street: Street
Town: Town
State: State
Zip: zip
Telephone: Telephone
FAX: FAX
E-mail: Email
Member/Candidate #: Mem_Number
Days Attending: Days_Attending
ASHI Member: ASHI_Member
State License:
NY-NY_LIC  NY_LIC_NUM   CT-CT_LIC  CT_LIC_NUM
NJ-NJ_LIC  NJ_LIC_NUM     MA-MA_LIC  MA_LIC_NUM
Are you a Professional Engineer: PE

If any of this information is incorrect, please go back to the registration form and change it. 

Please print this page for your records and include a copy when sending your check to:

NY Metro Seminar
25 Dahlia Drive
Mahopac, NY  10541
 
AFTER 9/5, PLEASE DO NOT MAIL YOUR PAYMENT - PLEASE BRING IT TO THE SEMINAR!!!!

Sincerely,

The NY Metro Annual Seminar Committee


You may return to the registration form by using the Back button in your browser.
Revised: August 11, 2012 .

UPCOMING EVENTS

                               

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Copyright 2004 NY Metro Chapter
Last modified: January 30, 2015