BCJS Registration Form

Web Registration Form
Representing the Holocaust

Complete this form and submit it.
Send a check payable to Lehigh University for the registration fee and meals to:

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.

REGISTRATION DEADLINE: May 8, 2000

Name:
Affiliation:
E-mail Address:

Mailing Address:
City, State:
ZIP/Postal Code:
Country:

Telephone:	Area/Country Code: Number: Extension:
FAX:	Area/Country Code: Number: Extension:
Comments:

Please register me for: e register me for:
Yes or No for each day Sunday, May 21 Monday, May 22Tuesday, May 23

Registration Fee:
I will send my registration fee of:
$10 for 1 day
$20 for 2 days
$25 for 3 days

Reception and Dinner, Sunday, May 21:
I will attend. An additional $30 will be included with my registration fee.
No, I will not be able to attend the opening dinner and reception. Choice of Entree:
Salmon
Vegetarian

Dinner, Monday, May 22:
I will attend. An additional $22 will be included with my registration fee.
No, I will not attend the dinner.

Choice of Entree:
Fish
Vegetarian

Box Lunch, Tuesday, May 23:
Order me a box lunch. An additional $8 will be included fee.
No, I do not want a box lunch.

Choice
Tuna
Vegetarian

Back to the Conference Home Page

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

Last modified 1/30/00 Shirley Ratushny

Registration Fee: I will send my registration fee of:	$10 for 1 day $20 for 2 days $25 for 3 days
Reception and Dinner, Sunday, May 21: I will attend. An additional $30 will be included with my registration fee. No, I will not be able to attend the opening dinner and reception.	Choice of Entree: Salmon Vegetarian

Web Registration Form Representing the Holocaust

Web Registration Form
Representing the Holocaust