Secure Registration Form

New York City Alumni Event

May 22, 2014

You may fill out this secure online form (read security info) and submit it here; you may print it, fill it out, and mail it to the address at the bottom of the form; or you may fax it to: Alumni Relations (315) 267-3172.

This form uses an automatic totaling script. If you have difficulty reading or submitting this form, the reason may be that your browser does not support forms or scripts. If you have questions or would like to request a paper copy of the registration form, you may call Laura Stevenson at (315) 267-2120 or e-mail alumni@potsdam.edu.

Please RSVP by May 16, 2014

Your name (required):
Nickname, for name tag:
Class year
Your address
City State/Province Postal Code
Phone number
E-mail address

Guests

If you're bringing more than 4 guests, please contact the Alumni Relations Office directly.

  Guest name (If Potsdam alum, include birth name) Nickname, for tag If alum, class year
1


2


3


4




Cost for event: $25 per person

Total number of attendees:   
Event amount:

6 p.m. Behind the Scenes Tour at the American Museum of Natural History. Space is VERY limited and will be on a first-come first-served basis. The tour will last 1 hour. Choose from one of three tour options:

      Number attending Ornithology & Microscopy Labs Tour
      Number attending Dinosaurs & Frozen Tissues Tour
      Number attending Genomics Labs Tour


6:30 p.m. - 9:30 p.m. Alumni Gathering and Reception at Citrus Restaurant. Appetizers will be provided. Cash bar.

      Number attending Alumni Gathering and Reception at Citrus

 Please do not list my name on the event website.

 I am pleased to provide the enclosed gift to support the SUNY Potsdam Alumni Association.
(Please fill out the credit card information below, or make checks payable to Potsdam College Foundation and mail to the address below. Thank you.)

If you are not making a gift at this time, please enter .00.

Gift amount: $


You may print out this form and mail it and your check (payable to Potsdam College Foundation) to:

Alumni Relations, SUNY Potsdam
44 Pierrepont Ave., Potsdam, New York 13676
phone: (315) 267-2120 fax: (315) 267-3172
E-mail: alumni@potsdam.edu

Thank you for registering for the this event.
A formal acknowledgment of your registration will follow shortly.

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