Name (as it should appear on name tag):
Affiliation:
Address: / City:
State: / Zip Code: / Country:
Email: / Phone:

Registration includes all paper sessions, concerts, field trips, lunch on Friday, andbanquet.

Postmarked before May 10Postmarked after May 10

Student$175 Student$225

$

Member$225 Member$275

Non-member$275 Non-member $325 Registration total

$

Buffet Banquet with lobster, chicken, and vegetarian options

Extra Banquet Ticket: $75/person…………………………………………………………………………………………………

Friday Box Lunch- Choose 1 (✓): Turkey Ham Vegetarian

Dietary Restrictions:

Field trips: Rank in order of preference (#1-4). Limited availability, First come, first served.

Powell Flutes and Zildjian Cymbals
Marlowe Sigal Instrument Collection
Frederick Piano Collection
MFA Instrument Collection

HOUSING: Air-conditioned dorm roomsare available at Simmons College from June 3-7 (check out-June 7).

Arrival: / Departure:

DEADLINE FOR HOUSING RESERVATIONS:May 19, 2015, First come, first served. Prices are per person and include linens and breakfast.

Price/night / # Nights / Total
$75.50/night x / =
$68.50/night x / =
$127/night x / =
$111/night x / =

✓:Choose 1

Single with private bath-limited availability ($75.50/person)……….

Single with common bath ($68.50/person)…………………………………..

Double* with private bath-limited availability ($63.50/person)……

Double* with common bath ($55.50/person)………………………………

*To book a double room, you will be charged for 2 people. / Roommate’s name:

I will NOT be staying at Simmons and have secured housing elsewhere

If you cancel your reservation between 60 and 30 days prior you will be billed for 75%, and if you cancel less than 30 days

prior to check-in you will be billed the full amount of the room cost. For access cards not returned at check-out you will be

billed $25 per card, and for room keys not returned at check-out you will be billed $50 per key.

Cancellations must be done through AMIS, rather than with Simmons College.

$ $

TOTAL REGISTRATION AND HOUSING:

PAYMENT (2 OPTIONS):

1. Pay online with credit card-Go to Send completed forms by email or post:

Click on “Join or renew by CREDIT CARD” (green button at left)EMAIL: Joanne Kopp ()

Fill out the online payment form with your total registration amount.MAIL: Joanne Kopp, Treasurer, AMIS

1106 Garden Street

2. Mail Joanne Kopp a check payable to: American Musical Instrument SocietyHoboken, NJ 07030

Questions? Contact Joanne Kopp (contact info above) or Jayme Kurland (; 617-369-3340)