New Netherland Dinner Registration 2007


Registration Form Please print and complete this form and mail it with a check payable to the New Netherland Institute, P.O.Box 2536, Empire State Plaza Station, Albany, NY 12220. NEW NETHERLAND RECEPTION AND DINNER THE TERRACE GALLERY, NEW YORK STATE MUSEUM ALBANY, NY SATURDAY, SEPTEMBER 15, 2007 AT 5:00 PM
NAME(S)	_________________________________________________________________________________
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AFFILIATION	________________________________________________________________________________

ADDRESS	________________________________________________________________________________

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DAY PHONE	____________________________	E-MAIL ______________________________________

NUMBER OF PERSONS @ $85 EACH	____	$________

To help support the work of the New Netherland Project and the New Netherland Institute, I/we add our donation of		$________

I/we are unable to attend, but to help support the work of the New Netherland Project and the New Netherland Institute I/we send my/our donation of		$________

TOTAL		$________

Payment must accompany registration. Cancellations cannot be accepted after September 7^th, and no refund will be issued after that date.

The New Netherland Institute is a not-for-profit membership corporation organized under New York State Education Law and is registered with the United States Treasury Department as a tax-exempt 501 © (3) organization. A copy of the Institute's latest annual report may be obtained from the Institute' directly or from the Attorney General, Charities Bureau, 120 Broadway, New York, NY 10271.