Registration Form
Name (required):
Title:
Agency:
Street Address:
City:
State: Zip:
Telephone (required):
Fax:
Email address (required):
Purchase Order/Voucher #:
Track Selections Place a check in the box for each track you plan to attend. Track 1 - Organizational Stability and Growth Track 2 - Board Development Track 3 - Creative Single Family Financing* Track 4 - Community Change Track 5 - Housing Rehabilitation v. New Construction Track 6 - Services for People With Special Needs* Track 7 - Real Estate Development 101 Track 8 - HOME Program Implementation Track 9 - Community Development Track 10 - Staff Development Institute Track 11 - Supportive Housing
* These conference tracks are underwritten by HUD, and conference attendees may participate in these tracks without charge, if they are not attending other conference events.
Conference Fees $205 - Tuesday Member Registration (includes 1 lunche and 1 dinner) $230 - Tuesday Non-member Registration (includes 1 lunch and 1 dinner)
$165 - Wedensday Member Registration (includes 1 lunch) $190 - Wednesday Non-member Registration (includes 1 lunch)
$285 - 2 Day Member Registration (Includes 2 lunches and 1 dinner) $325 - 2 Day Non-member Registration (Includes 2 lunches and 1 dinner)
Meals-only Options $25 - Tuesday Luncheon and Annual Meeting $35 - Tuesday Banquet and Keynote $25 - Wednesday Lunch
Please make your meal choices: Tuesday Lunch: Herb-crusted Haddock Herb-crusted Chicken Vegetarian Tuesday Dinner: Sesame Tuna Chicken Tuscany Prime Rib Vegetarian Wednesday Lunch: Steak Salad Chicken Strip Salad Portobello Salad
Please check the box and contact the Coalition before September 30, 2005 if you require assistance covered under the Americans with Disabilities Act. Please send me information on becoming a member of the New York State Rural Housing Coalition, Inc. today.
Or, return printed, completed Registration Forms to: David Rustin NYS Rural Housing Coalition, Inc. 879 Madison Avenue, 2nd Fl. Albany, NY 12208
Fax: (518) 458-8896
Refund Policy: All cancellations must be made in writing. A full refund will be made to anyone whose cancellation is received by
Send your comments, questions and suggestions the david@ruralhousing.org.