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Registration
Symposium on Energy in the 21st Century April 21, 2017

First Name*
Last Name*
Email Address*
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Address *
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Zip Code*
Work Phone
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Early Registration (until March 21st)
 Adult $60   
 Student $40   
 Limited Income $40   


After March 21st
 Adult $75   
 Student $50   
 Limited Income $75   


Please consider being a student sponsor or patron. We rely on our patrons & sponsors to bring you this Symposium
 Sponsor one student $50   
 Sponsor two students $100   
 Patron $100   
 Special Friend Patron $200   


For a tour, PLEASE CHECK ONE (buses provided)
 **Fenner Wind Farm Tour $25   
 **SU School of Engineering Grid Lab   
 **Tour of Anheuser-Busch Brewery & Sustainability $25  
 **SUNY ESF: Wood Chips to Ethanol Process $25   
 **Onondaga Composting Faculty (NEW) $25   
 **Onondaga Lake Cleanup & Restoration (NEW) $25   


**TO PAY BY CREDIT CARD press submit, follow the next page and add your total to the PayPal Cart. You will have the option to pay through PayPay or with a card.
*TO PAY BY CHECK,
press submit. Mail check.
Make check out to:
Energy21 Ltd
Mail to:
Dr. Rhea Jezer
Symposium
7426 Song Lake Road
Tully, NY 13159




CANCELLATION /CHANGE POLICY

Substitutions may be made in writing at any time. Cancellations must be submitted in writing by April 1st for refund. Send substitutions or cancellation by email to: rjezer@gmail.com

For billing questions contact Rhea Jezer rjezer@gmail.com. To become a sponsor with an ad in the program book, the website and on all mailings go to: www.energy21symposium.org and click on Sponsors.