46th Annual Public Affairs Seminar Cemetery Name / Organization * Address Address Address Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country Email * Phone Number * Fax Name * REGISTRATION OPTIONS Registration Options * All-Inclusive Two Day Registration (Includes All Meals & Reception) - $275 Two Day Registration (Does Not Include Monday Lunch) - $240.00 Spouse or Guest Two Day Registration (Does not include Monday Lunch) - $90.00 Monday Lunch (Optional) - $35.00 Monday Program Only (Meals and Reception Not Included) - $85.00 Monday Program Only with Reception/Dinner - $150.00 Tuesday Morning Program Only (Includes Breakfast) - $95.00 If you are not a cemetery or supplier member of NYSAC, please call the NYSAC Office at (518) 434-1134 for a membership application. Membership dues must be submitted with your conference registration. Sponsorship Options $500 Sponsorship OtherOther As a sponsor, your company's name will be included in the agenda distributed at the Seminar, as well as prominently displayed at the cocktail reception. In Addition, your company will be publicly acknowledged at the opening of all formal sessions. Additional Attendees. If you have an additional attendee you may add additional amounts here. If you have more than one additional attendee you must complete an additional form. All-Inclusive Two Day Registration (Includes all meals & Reception) - $275.00 Two Day Registration (No Monday Lunch) - $240.00 Spouse or Guest Two Day Registration (Does not include Monday Lunch) - $90.00 Monday Lunch (Optional) - $35.00 Monday Program Only (Meals and Reception Not Included) - $85.00 Monday Program Only with Reception/Dinner - $150.00 Tuesday Morning Program Only (Includes Breakfast) - $95.00 Cemetery Operations or Administration Questions Please write questions above or email Brendan Boyle at bjb@fwc-law.com. PAYMENT INFORMATION Pay by * I will be paying by Credit Card/Paypal Online I will be paying by check Total Due $ *All registration forms are due by April 22, 2022. *Registration will not be refunded unless NYSAC is notified 48 hours prior to the conference. *Please send hotel reservation and hotel payment to The Crowne Plaza, not to the NYSAC Office. Hotel Guarantee Cut-off Date is Monday, April 10, 2022. If you do not reserve a room within the block, then you will not receive the NYSAC rate or benefits. Please make checks payable ONLY to: New York State Association of Cemeteries ** Please do not use acronyms such as NYSAC or NYS Association of Cemeteries. IF PAYING BY CHECK SEE BELOW Mail this form and payment to: New York State Association of Cemeteries 111 Washington Avenue, Suite 501 Albany, NY 12210 If you have any questions please call the NYSAC office. Phone (518) 434-1134 Fax (518) 427-0452 info@nysac.com www.nysac.com Website/URL If you are human, leave this field blank.
