Professional Documents
Culture Documents
1969 - 2009
1969
1969 -- 2009
2009
―NATIONALLY KNOWN‖
1969 - 2009
Rooms are limited at Gurney’s Inn. ROOMS WILL BE ASSIGNED BASED ON REGISTRATION
DATE AND TIME. You can fax your registration to (631) 657-3480. Overflow rooms will be
available at the Montauk Manor. A shuttle bus will be provided.
LIASEA, INC.
PO BOX 144
Mastic Beach, NY 11951-0144
Phone: (631) 657-3731 or Fax (631) 657-3480
40TH ANNIVERSARY
1969 - 2009
REGISTRATION FORM
Please RSVP by January 16, 2009 with check payable to LIASEA, Inc. or Purchase Order to:
LIASEA, Inc., PO Box 144, Mastic Beach, NY 11951-0144
To reserve your space please FAX your Registration Form to 631-657-3480
Name:________________________________________________ Title:___________________________________
School District/Agency__________________________________________________________________________
Address:______________________________________________________________________________________
Business phone:___________________ E-Mail:____________________________
Emergency Contact Phone: (in case of inclement weather) Cell phone: _____________ Home phone:____________
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