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  1. TechBoot Registration
  2.  
  3. Name:
  4. Street Address:
  5. City:
  6. State:
  7. Zip Code:
  8. Email Address:
  9. I Would Like My Registration Code by  Mail  or  Email  (underline or circle appropriate)
  10.  
  11. Once filled out, please put this form in an envelope with $5.00 and address it to:
  12. Simon Kornblith
  13. 271 West College Street
  14. Oberlin, OH 44074
  15.  
  16. Thank You for Registering.