New Jersey Future Redevelopment Forum 2011

Secure Server Event Registration Form

Yes, I am interested in registering for New Jersey Future's 2011 Redevelopment Forum on March 4.

Please note that fields marked with an asterisk (*) are required.


Title:  *
First Name:  *
Last Name:  *
Alternate Contact:   
Street/P.O.Box:  *
Apt./Floor/Suite:   
City:  *
State:  *
Zip Code:  *
Company:   
Day Phone:  *
Evening Phone:   
Email Address:  *

Admission to the Redevelopment Forum is $85 for members and $125 for non-members and includes conference handout materials, breakfast and lunch. After February 17, admission is $100 for members and $140 for non-members. Admission at the door is $175, please bring check or purchase order on day of conference.

If you are not already a member, consider joining now for $50 to gain reduced admission plus all the benefits of membership for a total of $135. If you are not sure of your membership status, contact Dan Fatton at 609-393-0008, ext. 105.

NJF Membership(s) @ $50  (enter 0 if none)

Please enter # of attendees you are registering:
Members @ $85*  (enter 0 if none)
Non-Members @ $125*  (enter 0 if none)


Reimbursement for admission is possible until February 28, but there will be a $20 service fee.
No reimbursement will be given after March 1.



Please calculate the total payment amount (# of attendees x price)
Enter Total Amount*  .00


Credit Card Number* (Visa/MC only)
Expiration Date* /


Please indicate the name, title, and organization of each attendee
as you would like it to appear on their nametag.
 

After ensuring that all of the information above is correct,
please click the Submit Form Now button ONLY ONCE.
Multiple clicks of the Submit button will result in duplicate charges to your account.
An email confirmation will be sent to the email address you provided.



About SSL Certificates


  
NEW JERSEY FUTURE
137 West Hanover Street
Trenton, NJ 08618
Phone:609-393-0008 • Fax:609-393-1189
for more information please write to njfuture@njfuture.org


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