Fourteenth Annual Meeting
University of Pennsylvania, Philadelphia, PA
Friday and Saturday, April 8–9, 2016

Download as .pdf file.  

The downloaded registration form is an editable pdf file, which you can fill out on your computer, print, and then send to the MTSMA treasurer with payment.

MTSMA REGISTRATION FORM  2016

 

Name(s) 1________________________________ 2___________________________________

Institution(s) 1_____________________________ 2___________________________________

E-mail Address(es) 1_________________________    2_________________________________

Mailing Address(es) 
1____________________________________________________________________________

2____________________________________________________________________________

Banquet, Friday, April 8, 6:30 p.m. ($40 per person)
Harvest Seasonal Grill & Wine Bar
200 South 40th Street (40th & Walnut Street)
  How many?   _____      Total:  $ ______

 

 

Luncheon/Business Meeting, Saturday, April 9, 12:30 p.m. ($11.50 per person)
  How many?   _____     Total:  $ ______
   
Please select from the following boxed lunch options by circling both a sandwich and a side (all lunches also include cookie and piece of fruit).
 
Choice of Sandwich:
_____
 1) Dijon Tarragon Chicken Salad on Croissant with Lettuce

_____

 2) Smoked Salmon Salad on Croissant with Lettuce
_____ 3) Smoked Turkey and Swiss on Rye Bread with Apricot Mustard and Lettuce
_____ 4) Roast Beef on a Kaiser Roll with Horseradish Cream, Red Onion and Lettuce
_____ 5) Ham and Cheddar on Multi-grain Bread with Basil Mayonnaise and Lettuce
_____ 6) Nicoise Tuna Salad on a Kaiser Roll with Spinach
_____ 7) Guacamole, Cheddar, Cucumber, Alfalfa Sprouts and Tomato on Multi-grain Bread
_____ 8) Black Olive Goat Cheese, Roasted Red Peppers, Marinated Artichokes, Red Onion and Spinach on Baguette
   
Choice of Side:
_____ 1) Herbed New Potato Salad
_____ 2) Pasta Salad of the Day
_____ 3) Chili Spiced Cole Slaw


Registration (There are no dues. Automatic membership is by attendance or by e-mailing a request to Philip Duker at: pduker@udel.edu)

$55 if postmarked by March 28th; $60 after that or at the door**
  How many?  ______      Total:  $ ______
   
$35 for adjunct professors (or those with only part-time employment) if postmarked by March 28; $40 after that or at the door**
  How many?  ______      Total:  $ ______
   

$15 for retired people, students, and those not presently employed if postmarked by March 28; $20 after that or at the door**
  How many?  ______      Total:  $ ______
   
    Grand Total: $_______
   

**Those who mail this registration form by March 28th will be included on the list of pre-registrants to be distributed at our meeting. Please register as soon as you can so we can plan the refreshments, dinner, and luncheon for you.

Please mail this form along with your check made out to MTSMA to:

Eugene Montague, MTSMA Treasurer
2211 Ross Court
Silver Spring, MD 20910
eugene_m@gwu.edu
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