Workshop Registration Form

This workshop is being subsides by regional automation funds.

Select the workshop from the list:

It is very important that you include your email address and telephone number. Your confirmation will be emailed to you.

Please refer to the Workshop Details before completing the information below:

First Name:
(Required)

Last Name:
(Required)

Institution:
(Required)

Institution Name:
(If not listed)

Wednesday (11am - 6:30pm)

Yes No

Thursday (11am - 6:30pm)

Yes No

Work Phone:
(Required)

Home Phone:
(Required)

Home or mobile phone # in case we need to contact
you outside of normal work hours.

Email:
(Required)

We respect your privacy and we will not give your email
address to anyone.

Notes:

to complete your registration

Forms may also be mailed or faxed to:
Continuing Education
Southeastern New York Library Resources Council
21 S Elting Corners Rd.
Highland, NY 12528-2805
FAX: (845)883-9483