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To pay by Credit Card please complete the information below and fax or mail. If you are paying by check, please make check payable to Penn State University and mail with a copy of this form to: Pam Hileman, NERCRD, 7 Armsby Bldg., Penn State University, University Park, PA 16802.

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Expiration

Card Type: Visa/Mastercard, Discover, American Express

A block of rooms has been reserved at Days Inn Penn State at the rate of $95/night. To reserve a room call (814) 238-8454 or (800) 258-3297and mention reservation code CGNEST. The cut-off date for making reservations is May 2, 2008. Hotel information can be found at: http://www.lioncountrylodging.com/daysinn/index.php
Limited travel support scholarships will be available, up to $500, with priority given to those who would otherwise be unable to attend the symposium and whose paper or curriculum are accepted for presentation. Funds will be distributed equitably across the northeast region. To apply for a travel scholarship, please fill in the information below.

Name

Estimated Travel Expense

When you have completed every section of the form, you can either fax or mail the form to Pam Hileman, The Northeast Regional Center, 7 Armsby Bldg., University Park, PA 16802.

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