Registration Form
The Albany Symposium on Crime and Justice
October 6 and 7, 2006
All registration forms must be received by September 30, 2006
Registrant Information
Name______________________________________________________________________________________________
Organization_______________________________________________________________________________________
Address____________________________________________________________________________________________
____________________________________________________________________________________________________
Phone____________________________ Email_______________________________________________
UAlbany Alum (y/n)_____ Class Year(s) _________________ Degree(s)________________________
Parking pass is required to park at the University on Friday only (Sat. free). Please indicate if you need a parking pass mailed to you.
____ Yes - I need a pass
Payment Information
Conference Fee: $125
Includes: Leather portfolio, 2 lunches, breakfast, and reception
Please CHECK your payment option below:
| ___ | Check enclosed (payable to UAS: please indicate “The Albany Symposium on Crime and Justice” in the Notes) |
|
| ___ | Purchase Order |
|
| ____ | Credit Card Credit card type - circle one: Visa MasterCard Discover |
Name on credit card: _________________________________
Credit card number: _________________________________
Credit card amount: $ ________________________________
Signature: ________________________________________
| Please send this form and payment to : |
School of Criminal Justice University at Albany 135 Western Avenue Albany , NY 12222 FAX: 518-442-5212 |
| Questions? Call us at (518) 442-5214 or email symp06@albany.edu | |