Last Name
First Name
Company/Organization
Telephone:
Cell:
Email:
MEMBER ATTENDEE:
Staying at Andover Wyndham Hotel? (must register separately)	- please select - Yes No
Attending Forum on October 15?	- please select - Yes No
Attending Members Annual Meeting on October 16?	- please select - Yes No
Using Bus from Hotel to/from Merrimack College?	- please select - Yes No
Attending Open Bar Reception/ Dinner: (cost: $50.00)	- please select - Yes No
MEMBER'S SPOUSE/ SIGNIFICANT OTHER:
Spouse/Significant Other Attending?	- please select - Yes No
If yes, please provide name:
Spouse/Significant Other Going on New England Tour? (cost: $50.00)	- please select - Yes No
Spouse/Significant Other Attending Open Bar Reception/ Dinner: (cost: $50.00)	- please select - Yes No
MEMBER'S GUEST:
Guest Attending Open Bar Reception/ Dinner: (cost: $50.00)	- please select - Yes No
If yes, please provide name:

Please click submit and then you will have the option of paying with credit card (PayPal) or paying by check.

 

 

HOTEL DETAILS:

TO REGISTER AT ANDOVER WYNDHAM HOTEL, USE GROUP CODE: 1014781AID

Registration MUST take place by September  23^rd  in order to receive special $139 nightly rate.

Call: 800-996-3426 or 978-975-3600

Online hotel registration, Click Here