REGISTRATION FORM Fax to 518.462.5474


(Please print clearly. Use one form per attendee.)


Full Name: Nickname:

Phone: Email: Will this be your first-time attending NYSAR’s Business Meetings? (circle one)

Yes No

Event Name




Local Board/Association Leadership Conference

Sunday, 1 - 5 p.m.


Monday, 2:30 - 4:30 p.m.

Legal Update


Inaugural Dinner & Installation of Officers

$75/ticket by 1/29; $85 thereafter

Monday, 7 - 10 p.m.

Your meal selection: __ Chicken __ Beef __ Salmon __ Veg

Tuesday, 7 a.m. - 5 p.m.

RPAC VIP Lounge*


He Who Has the Money Sets the Rules CE session Instructor Development Program

Tuesday, 9 a.m. - Noon $50 Wednesday, 10:30 a.m. - Noon FREE!


Inaugural Dinner guest names/dinner selections (if applicable): _______________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________

Total amount to be charged to your credit card: $

If you have any disabilities which require special accommodations, including provisions for auxiliary aids/ services, please use this space to identify your needs. Or, contact Pam Morrison at 518.463.0300 x202 or via email at

Charge my (circle one): Visa MasterCard AMEX Discover

Credit Card #:

Security Code: Expiration Date:

Print Name as it appears on card:

Authorized Signature:

Billing Address:

Cancellation Policy: Registrations for the paid CE sessions may be canceled and payment will be refunded up until Sunday, January 29. After January 29, no refunds will be given. *RPAC disclaimer: Contributions are not deductible for federal income tax purposes. Contributions to RPAC are voluntary and used for political purposes. The amount suggested is merely a guide- line and you may contribute more or less than the suggested amount. You may refuse to contribute without reprisal and the National Association of REALTORS or any of its state associations or local boards will not favor or disfavor any member because of the amount contributed. 70 percent of each contribution is used by the State PAC to support state and local political candidates. Until your state reaches its RPAC goal, 30 percent is sent to National RPAC to support Federal candidates and is charged against you limits under 2 U.S.C. 441a; after the state reaches its RPAC goal, it may elect to retain your entire contribution for use in supporting state and local candidates.

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