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ASEE Mid-Atlantic Section Conference
College of Staten Island
November 2-3, 2001
NAME________________________________________
Affiliation_____________________________________
Early registration - before Oct 1, 2001_____$75;otherwise______$95
Additional Guest ____$25
Will attend workshop and complimentary dinner: yes____no____
Check payable to "The CSI Foundation-ASEE Conference".
OR
VISA___ MASTERCARD____ AMERICAN EXPRESS____ DISCOVER____
Card Number __________________________
EXP. Date___/___
Cardholder's Signature___________________________
Mail completed form and check/card information to:
College of Staten Island, Department of Engineering Science and Physics
ASEE Conference
2800 Victory Blvd.
Staten Island, New York 10314