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        REGISTRATION AND SPONSORSHIP FORMS:
    Conference on seniors: November 18, 2000 
                      by
NATIONAL INDO-AMERICAN ASSOCIATION FOR SENIOR CITIZENS Inc. (NIAASC)  
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               Registration form 
   for the Conference on Seniors on November 18, 2000: 
            (There is NO registration fees)
            RSVP by November 11, 2000  


Name: -----------------------------------------------   		
Telephone # (       ) ...............     .................

Address:-----------------------------------------------------------

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zip code.................   E-mail address:........................



Please mail to NIAASC 7 Roberta Avenue, Farmingville NY 11738

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                     Sponsorship form 
   for the Conference on Seniors on November 18, 2000  
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Please forward your sponsorship information with check as early as 
possible since names of the sponsors will be printed in the
program brochure:

Please check one:

Individual sponsor -------- 	   Not for Profit Group ------- 		   

Corporate/Other Group ..........  

Amount: ($50.00) 	($100.00) 	($250.00)

Name: -------------------------------------------------  
  
Telephone #   (          )  --------------   ---------------

Address--------------------------------------

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Display of products and/or literature etc.: Limited space is available
to those who wish to display their product or literature during the 
conference. There is a nominal charge of $200.00 for a table space.

Please print your name as you would like it to be printed in the 
program brochure. Please mail to NIAASC 7 Roberta Avenue, 
Farmingville NY 11738, with your check payable to NIAASC
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