The Modular Cleaning Program  November 2-5, 2009 Skaneateles, NY

Workshop Registration Form - Please print or write clearly

NAME:______________________________________________Tel 1 ________________: 2 ________________

ADDRESS:_________________________________________________________________________________

AFFILIATION:__________________________________________ Years in conservation: __________________

EMAIL:____________________________________________________________

Public transportation to and around Skaneateles is limited. Attempts will be made for participants to share rides. Please indicate transportation info below when known so we can plan car pooling and events. SYR airport is 45 minutes away. Amtrak station is 35 minutes.

Arrival by:_____________________________________________ Date and Time:______________________ _____

I would like to car pool and will share costs to airport if possible.    Yes       No

I will be staying at Stella Maris and have made my reservations:      Yes       No

BOOKING CONDITIONS: The small workshop is limited to 24 participants (including 4 from WLC), selected on a first come basis. An early registration with full payment will secure your enrollment. After October 1st, registrations may be considered on an individual basis due to the need to order materials in advance. Refunds are subject to a $25.00 processing charge and refilling the position.

WORKSHOP REGISTRATION FEE: (PLEASE INDICATE BELOW)

______$600.00 if not a member of AIC Paintings Specialty Group.

______$550.00 if a current paid member. Make check payable to West Lake Conservators: Credit Cards accepted: Visa/MC

CONFERENCE FACILITY FEES: Attendees staying at Stella Maris have all facility fees and meals included in their lodging @ $75.00 per night. If lodging elsewhere there is a $35 daily fee for workshop lunch and breaks, or $45.00 daily if dinner is also included. Please pay Stella Maris not West Lake for your lunch and other meals if you are lodging elsewhere. Please make your own Stella Maris reservations on line at their web site at stellamarisretreat.org and call them to confirm. The phone number at the retreat center is 315 685 6836. Mention the workshop as the West Lake MCP Program.

I enclose the full registration fee. Deadline October 1st I have read and understand the booking conditions above.

SINGNATURE:__________________________________________________DATE:___________________________

Check # ________________ Credit Card: Visa / MasterCard # ____________________________ Exp: ________

Card in the Name of:_________________________________________________

INQUIRES: West Lake Conservators, 315-685-8534 9am – 5pm. RETURN: Send completed registration form and your check (not including meals and lodging) to: West Lake Conservators Ltd., PO Box 45. Skaneateles, NY 13152