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To attend, please print out this form, fill it out and mail it with a check
made out to "ATMNYC" to:
EVELYN ESTRINE
TREASURER
3487 DANIEL CRESCENT
BALDWIN, NY 11510
516-223-3780
(FAX) 516-935-0008
mathronni@cs.com
Name ______________________________ e--Mail
_____________________________________
Address ____________________________________________________ Tel #
_______________
City/State/Zip
____________________________________________________________________
School ______________________________________________________ Level
______________
School Address ________________________________________ School Tel #
________________
Position __________________________________________
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