Mail Registration Form
Representing the Holocaust

REGISTRATION DEADLINE:  May 8, 2000

• Complete a printed copy of the registration form below.

Mail the form and a check payable to Lehigh University to the following address.

Berman Center for Jewish Studies
Lehigh University
9 West Packer Avenue
Bethlehem, PA  18015-3082
 

• A confirmation will be sent to you after your check has been received.

Name:             ________________________________________________________

Affiliation:      ________________________________________________________

E-mail Address:   ________________________________________________________

Mailing Address:

________________________________________________________
                  ________________________________________________________

City/state/zip:       _____________________________________________

Telephone:                  __________________________

Fax:                              __________________________
 
 

Please register me: _____for all three days ($25) _____for Sunday, May 21 ($10) _____for Monday, May 22 ($10) _____for Tuesday, May 23 ($10) Reception and Dinner, Sunday, May 21: ____ I will attend.  An additional $30 is included with my registration fee. Dinner, Monday, May 22: ____ I will attend.  An additional $22 is included with my registration fee. Box Lunch, Tuesday, May 23: ____ Please order a box lunch for me. An additional $8 is included with my registration fee.

Sunday Entree: ___ Salmon ___  Vegetarian Monday Entree: ___ Fish ___ Vegetarian Tuesday Lunch: ___ Tuna salad ___Vegetarian

URL: http://www.lehigh.edu/~inber/inber/regmail.html