To attend, please print out this form, fill it out and mail it with a check made out to "ATMNYC" to:

EVELYN ESTRINE
3487 DANIEL CRESCENT
BALDWIN, NY 11510-5153

Name ______________________________  e--Mail _____________________________________

Address ____________________________________________________  Tel # _______________

City/State/Zip  ____________________________________________________________________

School ______________________________________________________  Level ______________