Re s e r vati o n I nfo rm ati o n __________________________________________________________________________ Name (Please print clearly.) __________________________________________________________________________ Company Name (if applicable) __________________________________________________________________________ Title (if applicable) __________________________________________________________________________ Address __________________________________________________________________________ City State ZIP __________________________________________________________________________ Telephone Email Dietary Preference:
o Vegetarian
Celebration of
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o Kosher
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Please provide reservation and payment information by November 4, 2014, and return in the enclosed envelope or mail to National Center for Suburban Studies at Hofstra University, 250 Hofstra University, Hempstead, NY 11549-2500; or fax to 516-463-3907. All contributions are tax-deductible to the extent allowed by law. Proceeds benefit diversity-related scholarships, research and community-based initiatives. printed on recycled paper
Reservation Information and Giving Opportunities