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REGISTRATIONTechnology and Services Today and BeyondThis One-Day Conference will be held on March 5th, 2016, from 8:30am to 5:00pm at the following location: Center for the Visually Impaired739 West Peachtree St. NW Atlanta, GA 30308Name: Phone Number: Address: AER Member #: Email address: A boxed lunch and drinks will be provided. Please indicate your choice by placing an X in front of one of the choices below. Soft drinks, tea and coffee will also be provided: Mediterranean Veggie Sandwich Smoked Turkey Sandwich Smoked Ham & Swiss Sandwich___ Classic Salad with balsamic vinaigrette dressing___ Greek Salad with herb vinaigrette dressing___ Caesar Salad with Caesar salad dressing ___ w Croutons ___ w/o Croutons - gluten free*all salads gluten free except Caesar salad; please indicate with or without croutonsCost of Registration (select applicable option by placing an X in front of the option that applies to you): Member of AER (Georgia Resident): $20.00 Cost per child accompanied by parent: $35.00 Member of AER (non-resident of Georgia): $35.00 All Students, regardless of school being attended):$35.00 Parents of children with visual impairment:$35.00 Non-member of AER: $60.00___ Driver for visually impaired attendee$10.00 (includes lunch)(Lunch and drinks are included with registration fee)Total amount enclosed: (check or money order accepted): $Preferred format for handouts if required: (Braille or Electronic):Please send the completed form, along with registration fee, to the mailing address below. Registration may also be sent electronically at the following email address, and fee paid at the door, but only if exact change or check is provided: lmwilliams1951@gmail.com Linda Williams1208 Valley Drive NE Conyers, GA 30012-4632 |
