Name(S)         ________________________________________________________

Mailing Address ________________________________________________________

                ________________________________________________________

City            ________________________________________________________

State           ________________________________________________________

Zip Code        ________________________________________________________


Phone           ________________________________________________________

Email address   ________________________________________________________


           ____ Number of full registrations 
                               $145 each until 8/15/2007 thereafter $155

           ____ Number of Saturday-only registrations
                           $72.50 each until 8/15/2007 thereafter $77.50

           ____ Number of vegetarian meal plans requested


Make check payable to "Mid-Hudson Mensa - RG" and send to:

       Nancy Keyes-Crosby, registrar
       P.O. Box 243
       West Park, NY 12493

Registration must be received by September 4, 2007.

For additional information or to let us know that you might arrive later 
than 5:00 P.M. on Friday, contact:

       Bill Zigo  at bzigo@optonline.net or (845) 229-8746.