CONSULTING IN UPSTATE NEW YORK
Starting and Developing Your Consulting Business

Presented by
Rochester Professional Consultants Network
Tuesday, May 4, 2004
Radisson Hotel, 175 Jefferson Road, Rochester, NY 14623

REGISTRATION FORM
Please fill out and print.

If you prefer, download the registration form here
to print it, fill it out, and then fax or mail it to RPCN.
See instructions below.
(You will need Adobe Acrobat Reader software to open the downloaded form.)

Bolded items are required.
Name:
Title:
Name for Nametag:
Company/Affiliation:
Mailing Address 1:
Mailing Address 2:
City/Town:	State:    Postal Code:
Country:
Phone (incl area code):
Fax (incl area code):
E-Mail:
Web Site URL:

I'm registering as follows (Check all that apply):

RPCN Member   Non Member   Speaker   Non Member   Exhibitor

Amount Enclosed:

	Early Registration	(Before 3/31/04) Registration	(After 3/31/04) At TheDoor
RPCN Members	$100	$120	$140
Non-Members*	$120	$140	$160
Exhibitors-Members	$300 Includes admission for 2 people, conference, lunch, one 6' table.
Exhibitors-Nonmembers	$395 Includes admission for 2 people, conference, lunch, one 6' table.

*For free information about joining RPCN, call (585) 244-1060.

Special Needs? Call RPCN at (585) 244-1060
Please make checks payable to R.P.C.N. Conference. Checks must be in US dollars.