2012 Local Roads Matter Grassroots Campaign

Please complete the contact details below to complete your registration for the 2012 Local Roads Matter Grassroots Campaign.

Email Address *

Advocacy Day Registration Details

First Name *
Last Name *
Town/Organization *	(Please provide full name - for example: "Town of Middlesex", "Albany County DPW", "International Truck & Engine Corp.")
Event Sponsorship	Yes I would like to sponsor an Advocacy Day event. Please contact me to discuss my participation.
Cancellation Agreement *	Yes I agree to pay a registration processing fee of $75.00 should I register then fail to cancel in writing prior to the event.

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NYS Association of Town
Superintendents of Highways
136 Everett Road
Albany, NY 12205
Phone: 518.694.9313
Fax: 518.694.9314
info@nystownhwys.org

Associate Member dues are $200.00; Town Superintendent's $150.00 per annum. No further assessments are made.