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Mail-In 2013 Membership/Seminar Registration


 MABB Spring 2013 Seminar Registration

Please print this form and mail it with payment to:

Massachusetts Association of Blood Banks
PO Box 3856
South Attleboro, MA 02703


Make checks payable to MABB.

   Early Bird Rate
Before April 1, 2013
 
After April 1, 2013
 MABB Members  $70  $100
 Non-members  $90  $100
 Students  $35  $35
Your mail must be postmarked by April 1 to be eligible for the early bird discount.

You can join MABB for a low $20 annual fee at any time!

Your registration fee includes a continental breakfast, a catered luncheon buffet, and refreshments throughout the day.

 
If you are registering multiple attendees, please use an individual form for each person. 
(You can submit fees on just one check).

 Amount Submitted:
 
_$______________ Spring Seminar Fee

_$______________ MABB Annual Membership Fee

 Name:
 
______________________________________________________________
 
Email:
 
______________________________________________________________
 
Phone:
 
______________________________________________________________

  Occupation:
 
______________________________________________________________
 
Organization:
 
______________________________________________________________
 
Address:
 
______________________________________________________________
 
City:
 
______________________________________________________________
 
State:
 
__________________
 
Zip:
 
__________________

Is this address your home or work address?
 Home
 Work

 If you are a full time student, what school are you attending?

_________________________________________________________