Associated Colleges of the St. Lawrence Valley

Together We Can Do More

North Country Higher Education Opportunities
Academic Counselors Conference

Programming is scheduled from 11:00 a.m. on Tuesday, April 22, 2008 through 2:45 pm on Wednesday, April 23, 2008

After you fill in the required information, click Send Now. The information will be sent to Kaipo Rogers:acslv@potsdam.edu at Associated Colleges of the St. Lawrence Valley. Thank you.

The registration deadline is April 1st


	Fields marked with * are required.

* Name:
* School:
* School City:
* School State & Zip Code:
* School Phone:
* Home Phone:
* School Fax:
* E-mail:
* Today's date:
* I am a:	Non-smoker Smoker
* I am:	Male Female
* Special Dietary Concerns
* Mobility concerns, hearing or vision limitations?
* Roommate Preference?	No Yes , I wish to share a room with: from the school.
* I would like a PRIVATE ROOM at a cost of approximately $42.50	Yes No
Additional Comments:
I understand that I will be billed at checkout for all charges incurred except room and scheduled meals.
Please contact Kaipo Rogers (315) 267-3331 or asclv@potsdam.edu within a week to be sure that the form has worked properly. Thank you.

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