RECEPTION TABLE REQUEST FORM

IMPORTANT NOTE: DUE TO POLICY CHANGES WITHIN THE APA, ALL TABLE RESERVATIONS MUST BE PAID FOR AT THE TIME OF PLACING THE RESERVATION. WE WILL BE UNABLE TO PROCESS YOUR FORM WITHOUT THE ACCOMPANYING PAYMENT. THANK YOU FOR YOUR UNDERSTANDING.

Receptions are scheduled to be held in the Red Lacquer Room on April 27th (8:30 p.m. to midnight) and in the Red Lacquer Room on April 28th (9:00 p.m. to midnight). The first night reception provides beer and soft drinks at no charge. Admittance is by registration name badge or ticket only. The second night reception is a cash bar. The charge for a table at both receptions is $25.00 total. To reserve a table, please complete the following and return to Linda Smallbrook, APA, University of Delaware, Newark, DE 19716; or fax the form to 302-831-3372.

Name:_________________________________________________________________

School/Organization:_____________________________________________________

Address: ______________________________________________________________

______________________________________________________________________

Office Phone: ______________________Fax:_________________________________

E-mail address: ________________________________________________________

Please select an option for payment:

___ 1) Check* (Payable to APA)

*The APA can only accept checks drawn on a U.S. bank, in U.S. Dollars.

The deadline for reception table requests is April 7, 2006. Reservations received after that date will not appear on the list distributed to attendees; however, they will be posted at the entrance to the receptions.