Registration

Registration Form
The 6th Annual Hudson Valley
Obsessive-Complusive Disorder Conference
Tuesday, June 12th, 2001

Fees
Afternoon Session Only $6.00
Evening Session Only $6.00 Full Day Event with Dinner $26.00

Fees for Walk-ins Day of the Event                                   Afternoon Session Only          $7.00
                                  Evening Session Only             $7.00
                                  (No Dinner Avaliable for Walk-Ins)

Please print, fill out and mail your registration and fee payable to the:

Mental Health Association in Dutchess County,
510 Haight Avenue, Poughkeepsie, NY 12603

Registration Deadline: Wednesday June 6th

NAME ______________________________________________________________

ADDRESS ___________________________________________________________

______________________________________________________ZIP ___________

PHONE(Day) ______________________________________

(Evening)__________________________________________

AMOUNT ENCLOSED: _________________

Please check the appropriate session:

__________Afternoon Session Only                     $6.00
__________Evening Session Only                        $6.00
__________Full Day Even with NO Dinner         $12.00
__________Full Day Event with Dinner               $26.00

For information, contact the Mental Health Association in Dutchess County at (845) 473-2500 x319.
Calls may not be returned on a daily basis but will receive a response.

For web problems email chris.vertullo@marist.edu