Registration
Recipe for College Success Conference
Adirondack Community College, Queensbury, NY
Monday, March 12, 2007

Name:_________________________________________________________________________

Address:_______________________________________________________________________

School District:__________________________________________________________________

Phone:_________________________________FAX:___________________________________

E-mail:______________________________________________________

Registering as a: student    parent    school/agency personnel

Pre-Registration is required by March 7th and must include a check or PO made out to FSA of ACC for $6.50 to cover the cost of lunch. No late or walk-in registrations will be accepted.

Please choose ONE workshop for each concurrent session and circle your choice on the chart below. (See attached list for descriptions and times).

Concurrent Session #1: A B C D Concurrent Session #2: E F G H

Special Dietary Restrictions:________________________________________________________

(please specity)

Special accommodations: Every effort will be made to accommodate special needs. For registrants requesting accommodations to be provided by the conference planning committee, make sure that your registration is received by February 27, 2007. Please state the accommodations that you will need:

______________________________________________________________________________

You will be contacted by a member of the planning committee to discuss the details.

Please mail ONE registration form per person. Use a photocopy of the registration form for multiple registrations. Mail your completed registration form and fee to:

Jamin Totino, Director of Accessibility Services

Adirondack Community College, 640 Bay Rd., Queensbury, NY 12804

If you have questions, please contact Jamin at totinoj@acc.sunyacc.edu or (518) 743-2282

or Lorna Snapp at WSWHE BOCES, (518)581-3646, or lsnapp@wswheboces.org