Please type your information into the form below,
then print and mail with your check to the address below.
City: State: ZipCode:
Names of others in your party (include relationship to you):
Staying at the Convention Hotel: YES NO
Events you are planning to attend (fill in the number of persons attending each event):
Friday: NEHG Casual Dinner
Saturday: Morning AS meeting Casual
Ames Society Dinner Casual
Total number of persons attending on this form @ $10 each = $
Please make checks payable to: The Ames Society
Cancellation Policy: All cancellations must be received in writing or email
prior to September 1, 2016. No refunds after that date.
Reminder: Information can be found on the Convention webpage. Call the hotel directly
to get the Ames Society group rate on your hotel reservation - (508) 559-0099.
Please print and mail this form and payment to:
The Ames Society, c/o Bruce C. Lyon, 200 Luchon Rd, Willington, CT 06279
Updated 4 June 2016