THE NEW YORK TREASURERS' DINNER
REGISTRATION FORM

MONDAY, October 23, 2017
5:30 p.m. - 8:00 p.m.

THE YALE CLUB OF NEW YORK CITY
50 Vanderbilt Avenue


Please print or type the information requested. Your badge name and company should appear as you want them to appear on your badge. Payment in full must accompany this registration form. Cancellations must be made in writing by not later than October 16, 2017. Written notice of cancellations received at NACT headquarters by October 16 are entitled to a full refund. Registration cancellations received on or after October 16, 2017 are nonrefundable.

* = required
First Name: *
Last Name: *
Badge Name:*
Title:*
Company: *
Mailing Address Line 1: *
Mailing Address Line 2:
City: *
State/Prov.: *
Zip+4: *
Daytime Phone: *
Fax:
E-mail: *


Payment Information

Fees
Attendee Registration   * $75
Total Due:
 
Charge the above amount to *

American Express Card    Master Card    Visa  
Card Holder Name: *
Credit Card Number: *
Expiration Date: * /
 
 
Enter the text above: *