The Antique Jewelry & Art Conference. Inc. 39 Leonard Lane Centereach, New York 11720, Ph: 631-471-5232 Fax: 631.471.1922 Jewelry 2010 To Pay By Credit Card or Check Please call Sandy Lewand at 631-471-1922 (Please Print) Last Name:___________________________ First Name:__________________________ PLEASE CALL 631-471-1922 OR 631-471-5232 TO REGISTER WITH CREDIT CARD OR SEND ME AN EMAIL TO Company Name:________________________________________________________________________ Address:______________________________________________________________________________ City:____________________________ State:___________ Zip (postal) code:_____________________ Country:___________________ Phone :____________________ Cell Phone:______________________ Fax:_______________________ Email:__________________________________________________________________ Emergency contact information: Name:__________________________________________________________________ Relationship:_________________________________________ Phone:______________________________________ Jewelry 2010 16th thru 18th Tuition Tuition $595.00 IF PAID BY April 30th $545.00___________________________________ ______________ IF PAID AFTER April 30th $595.00________________________________ ______________ University Fee(mandatory fee) $75.00______________________________ ______________ For special group and student discounts, please call for details Sandy Lewand 631-471-1922 HOUSING: Dorm suites consist of two private bedrooms with a shared bathroom and are air conditioned, fridge and microwave in a secure building. All dorms are within a two minute walking distance of the conference center. Housing is $85.00 per night (Friday and Saturday), early and late departure evenings are available. A non-refundable $10.00 key charge that can also be used for the meal plan is required. Keys do not need to be returned. Friday & Saturday $85.00 per night ____________________ ______________ Early Arrival evening of July 15th $85.00______________________ ______________ Late departure evening of July 19th $85.00____________________ ______________ Total of tuition and housing with University fee.......................................... $______________ Registration will not proceed without full payment. SPECIAL DAY RATE $200.00 per day and $25.00 University fee per day. Please indicate which day Friday Saturday Sunday Checks must be in US funds and drawn on a US bank, made payable to: The Antique Jewelry & Art Conference, Inc. Mail to: Antique Jewelry & Art Conference  39 Leonard Lane Centereach, NY 11720 Credit card registrations are accepted by phone or fax please call Sandy Lewand at 631-471-1922 Cancellation Policy: Cancellation is allowed up to June 22, 2009 less a $50.00 handling fee and credit card fees incurred. After June 22nd handling fee is $100.00 and credit card fees incurred. No refund after the conference has started.

The Antique Jewelry & Art Conference. Inc.

39 Leonard Lane Centereach, New York 11720, Ph: 631-471-5232 Fax: 631.471.1922

Jewelry 2010 To Pay By Credit Card or Check

Please call Sandy Lewand at 631-471-1922

(Please Print)

Last Name:___________________________ First Name:__________________________

PLEASE CALL 631-471-1922 OR 631-471-5232 TO REGISTER WITH CREDIT CARD OR SEND ME AN EMAIL TO

Company Name:________________________________________________________________________

Address:______________________________________________________________________________

City:____________________________ State:___________ Zip (postal) code:_____________________

Country:___________________

Phone :____________________

Cell Phone:______________________

Fax:_______________________

Email:__________________________________________________________________

Emergency contact information:

Name:__________________________________________________________________

Relationship:_________________________________________

Phone:______________________________________

Jewelry 2010 16th thru 18th Tuition

Tuition $595.00

IF PAID BY April 30th $545.00___________________________________ ______________

IF PAID AFTER April 30th $595.00________________________________ ______________

University Fee(mandatory fee) $75.00______________________________ ______________

For special group and student discounts, please call for details Sandy Lewand 631-471-1922

HOUSING: Dorm suites consist of two private bedrooms with a shared bathroom and are air conditioned, fridge and microwave in a secure building. All dorms are within a two minute walking distance of the conference center.

Housing is $85.00 per night (Friday and Saturday), early and late departure evenings are available. A non-refundable $10.00 key charge that can also be used for the meal plan is required. Keys do not need to be returned.

Friday & Saturday $85.00 per night ____________________ ______________

Early Arrival evening of July 15th $85.00______________________ ______________

Late departure evening of July 19th $85.00____________________ ______________

Total of tuition and housing with University fee.......................................... $______________

Registration will not proceed without full payment.

SPECIAL DAY RATE $200.00 per day and $25.00 University fee per day.

Please indicate which day Friday Saturday Sunday

Checks must be in US funds and drawn on a US bank, made payable to: The Antique Jewelry & Art Conference, Inc.

Mail to: Antique Jewelry & Art Conference
39 Leonard Lane
Centereach, NY 11720

Credit card registrations are accepted by phone or fax please call Sandy Lewand at 631-471-1922

Cancellation Policy: Cancellation is allowed up to June 22, 2009 less a $50.00 handling fee and credit card fees incurred. After June 22nd handling fee is $100.00 and credit card fees incurred. No refund after the conference has started.

Notice: The Early Registration Discount Period has been extended until April 30, 2010