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Registration form
        NYS-Specific Exam Review Workshop • September 22-23, 2023                    About the presenters:
        Register ONLINE now at www.nysapls.org OR complete this form today.                      Dr. Joseph  V.R. Paiva,
                                                                                                 is principal and CEO
        NAME: _________________________________________________________
                                                                                                 at  GeoLearn,  LLC
        ADDRESS: ______________________________________________________                          (www.geo-learn.com)
                                                                                                 which is an online
        CITY: ___________________________STATE: __________ ZIP: ___________
                                                                                                 provider of professional
        WORK #: (____)__________________    FAX #: (____)___________________         and technical education since February
                                                                                     2014. He previously served as a
        HOME #: (____)__________________    E-MAIL:  ______________________
                                                                                     consultant in the field of geomatics
                                                                                     and general business, particularly to
         Members                                                                     international developers, manufacturers
         By September 1 st                  After September 1 st                     and distributors of instrumentation and
           1st Time Attendee $329            1st Time Attendee $379                other geomatics tools. In that role Joe
           Repeat Attendee $279              Repeat Attendee $329                  functioned as COO at Gatewing NV,
         Non-Members                                                                 a Belgian manufacturer of unmanned
         By September 1 st                  After September 1 st                     aerial systems (UAS) for surveying and
           1st Time Attendee $429            1st Time Attendee $479                mapping during 2010-2011. He also
           Repeat Attendee $379              Repeat Attendee $429                  is a writer in many magazines and
                                                                                     journals and  has  been  on  the  “seminar
        Payment Method:                                                              circuit,” delivering continuing education
         Check or Money Order Enclosed (make payable to NYSAPLS)                    to geospatial professionals, as well as
                                                                                     technician and exam preparation courses.
         Please charge my    VISA    MASTERCARD    AMEX    DISCOVER
        Acct #: __________________________________________________________
        Exp. Date: ___/___ Verification Code: __________                                         Richard  C.  Brooks,  LS
        Signature:  _______________________________________________________                      is  a  Land  Surveyor
                                                                                                 licensed and practicing
        Billing Address:  ___________________________________________________
                                                                                                 in  New  York  State
        Name as it appears on card: __________________________________________                   Licensed in 1984, he is
        Return this form along with payment to:                                      the senior project manager for Control
        NYSAPLS, 146 Washington Ave., Albany, NY 12210                               Point Associates, Inc. at their Hudson
        Questions?Please call, (518) 432-4046, fax (518) 432-4055 Or email, info@nysapls.org

                                                                                     Valley office. Richard has spent his
        NEW! Option to Protect Your Registration*                                    professional career in and around the
        We now offer cancellation insurance through Allianz Global Assistance, a third party provider.   Catskill Mountain region.Mr. Brooks is
        The insurance is ONLY available by registering for this event on our website with a credit card
        payment. Register online at www.nysapls.org for more details.                a past president and current member of
                                                                                     the Mid-Hudson Valley Land Surveyors
        NYSAPLS Cancellation Policy
        Payment must be made in full upon registration. Purchase orders not accepted. Cancellations   Association. In addition, he is a current
        submitted in writing 30 days or more prior to the event, will be granted a 100% refund, less a 10%   member  of: NYSAPLS,  VSLS, NSPS,
        processing fee. After the 30 day window, I understand that my event ticket purchase is intended to   NYS GIS Association and the Surveyors
        hold my reservation. Therefore, 0-29 days prior to the event, registration fees are non-refundable   Historical Society. Mr. Brooks is also
        unless I obtain the cancellation insurance provided by Allianz Global Assistance, a third party   an  adjunct  profession  at  SUNY  Ulster
        provider, during online checkout. Register online at www.nysapls.org for more details.
                                                                                     College, teaching Legal Aspects of Land
        In accordance with Title III of the Americans with Disabilities Act, we invite all registrants to   Surveying and Land Use Management.
        advise us of any disability and any requests for accommodations to that disability. If you have any
        questions, please call the NYSAPLS office at 518-432-4046.
        By submitting this form, I acknowledge the cancellation policy above and understand I do not
        have an option to obtain cancellation insurance.
        *Signature: _______________________________________________________________





                                                EMPIRE STATE SURVEYOR / VOL. 59 • NO 4/ 2023 • JULY/AUGUST   25
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