2009 CONVENTION ADVANCE REGISTRATION FORM

Member Name:         ________________________________________________________________

Address:                     ________________________________________________________________

                                    ________________________________________________________________

Telephone:     _________________________    Fax:         _____________________________

E-mail:            _________________________________

Arrival Date:  ____________________           Departure Date:  ____________________

Number of Adults:   ____      Children:   ____   Guests:   ____

Names of Guests: ______________________________________________________________

IF YOU ARE NOT STAYING AT THE HOTEL, PLEASE PROVIDE US WITH YOUR LOCAL ADDRESS AND TELEPHONE NUMBER

Member Advance Registration Fee Enclosed:  $________  @ $450.00 per couple

Non-Family Guest Advance Registration Fee Enclosed: $________  @ $450.00 per couple

REGISTRATIONS RECEIVED AFTER NOVEMBER 19, 2009 ARE $500.00 PER COUPLE

If early registration is canceled by December 15, 2009, there will be a full refund less a $25.00 administration charge.

Return your completed advance registration form and check payable to TER to:

                                                ALAN M. TEPPER, ESQUIRE
                                                National Executive Director
                                                133 Paisley Place  
                                                Hainesport , New Jersey 08036  
                
                                                (609) 864-1838
                                                tepesq@verizon.net or director@ter-law.org