MRVector Newsletter American Registry of Magnetic Resonance Imaging Technologists Phone: 718-347-8690 Fax: 718-347-8691 E-mail: [email protected] www.armrit.org

Raymond V. Damadian, MRI Imaging Machine Summer/Fall Issu e 2010

Inventor - Keynote Speaker Vol. XVI No. 2

ARMRIT 5th Annual Meeting in Las Vegas Inside this issue: New York, NY. Dr. Oregon to License MRI Raymond V. The American Registry of The “Henry Ford” of MRI Includes ARMRIT Damadian Speaks @ MRI Technologists is proud (reprint from previous issues) Certification ARMRIT 2010 to announced that Raymond Long Island, New York Portland, Oregon V. Damadian the inventor of When Raymond Damadian Oregon Board of Damadian - The “Henry Ford” of MRI the MRI scanner and the first was a boy, he lost his Medical Imaging to perform a total body MRI Grandmother to a slow death (formerly OBRT) has Oregon Licenses MRI by cancer. This loss affected ARMRIT Included scan of the human body in included ARMRIT 1977 has accepted the him greatly. Young certification as a West Virginia ARMRIT invitation to be its Damadian vowed to find a requirement to be eligible Licenses MRI, keynote speaker at its 5th way to detect this dreaded for a Medical Imaging ARMRIT Included Annual meeting and seminar. disease in its early stages, Technologist License to and still treatable, so that ARMRIT 2010 The meeting will be held on practice MRI Technology. th others could be saved. Thus, 5 Annual Meeting & October 21-23, 2010 at the To view the first Oregon Seminar a lifetime goal was set at an elegant Stirling Club in the licenses awarded to Turnberry Towers complex early age. ARMRIT certified MRI CMS Requirements on Paradise Road, in Las Of Armenian descent, Techs see page 5. for January 2012 Damadian grew up in Forest Vegas, Nevada. (Cont. on page 3) CME requirement Dr. Damadian is a native Hills, New York. In his New Yorker, graduated from childhood years Damadian West Virginia Medical Albert Einstein School of attended the Julliard School Imaging and Radiation ARMRIT 2010: and became very proficient Medicine in Bronx, New TherapyCaption Technology describing 5th Annual Meeting & York, did his MRI research at playing the violin. He also Board pictureof Examiners or graphic. Seminar Downstate Medical Center, in played and won many Wheeling, WV Oct. 21-23 Brooklyn, New York, junior championships. Prior to Oregon, West established and located his Damadian was introduced Virginia has included Stirling Club company at Melville, New to NMR by Edward Purcell ARMRIT certification as a @Turnberry Place York where he lives. at Harvard University when requirement for a license to Las Vegas, Nevada The title of his lecture is Purcell drew an NMR practice MRI Technology. "The History and Genesis of spectrum on a blackboard as For Accommodations: MRI, A Machine Called part of a course he was Centers for Medicare @ the World Famous Indomitable". The Registry teaching. This subject and Medicaid Services Las Vegas Hilton has already received sparked Damadian’s interest (CMS) has established thru September 21, 2010: numerous inquiries from its immediately. accreditation requirements certified techs that if he is in After a tour of duty in for providers of advanced Call Directly: 800-635-7711 fact coming to the meeting military service and medical medical imaging mandated between 6:00am to 12am and will be a speaker. His school at Albert Einstein by the Medicare Daily. Ask for Rooms for lecture is very much College of Medicine in New Improvements for Patients the ARMRIT group . anticipated and everyone York, Damadian joined the and Providers Act of 2008 looks forward to learn how faculty of Downstate (MIPPA). Providers must Fill Out Registration Form this indomitable machine Medical Center in Brooklyn, comply with CMS’ On Page 9 and Fax to: came to be invented and New York. About this time requirement that all 718-347-8691 eventually fully accepted as a Dr. Damadian began to providers of CT, MRI, PET Or visit www.armrit.org revolutionary imaging experience persistent & Nuclear Medicine, be and Click on the diagnostic tool. Don't miss abdominal pain. accredited by Jan. 1, 2012, Acteva Box! this historic event. (Cont. on page 2) in order to be reimbursed. Wilfrido M. Sy, MD

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Damadian ( cont. from page 1) around the mouse. In an attempt to get a construction of a superconducting magnet. He had rarely been sick. The possibility of clearer focus, the current was increased The design was called the “Helmhotz cancer entered his mind. Although the pain continuously. Unfortunately this cooked Pair”. It consisted of two hoops of subsided eventually, this was the spark “pioneer mouse”. On March 11th, 1976, Niobium-titanium wire wrapped around which ignited the interest in developing a Dr. Larry Minkoff, an assistant to Dr. many times to produce a solenoid. When method to view the human body’s interior Damadian, was able to produce a crude attached to a power source, the magnet for early detection of disease. image of a tumor on the anterior chest wall would have a field strength of five Using a primitive NMR machine, Dr. of the second pioneer mouse. thousand gauss (0.5T). All other magnets Damadian found that he could distinguish Everywhere Dr. Damadian spoke about of this size were part of nuclear between normal tissue and cancerous NMR and its possible application to detect accelerators. tissue in rats implanted with tumors. cancer in humans; it seemed everyone was One concern was the effect of having During testing, he found that T1 and T2 talking about ’s technique two extremely powerful magnets in the relaxation times for healthy and unhealthy called Zeugmatography. Damadian was same room. There was the possibility that tissue were noticeably different. fearful that Lauterbur would get credit for the supporting structure would not be Discovering that the NMR machine was his ideas and receive recognition that was sufficient to keep the magnets apart and useful in detecting cancer, Damadian rightfully his. could slam together with tremendous envisioned its use in the detection of heart Also in February 1976, Damadian’s force. A scary prospect indeed. and kidney, as well as mental disease. team, consisting of Larry Minkoff and By a stroke of good luck, the team was After publishing his article in “Science” Mike Goldsmith were ready to construct a able to obtain superconducting wire for magazine in 1971, many individuals in the machine large enough to scan a human. pennies on the dollar from Westinghouse scientific and NMR community considered Finding that their funds were insufficient when the company decided to get out of Damadian’s ideas to be far out in left field. to buy a magnet, they decided to build the superconducting wire business. At the They saw NMR as a test for high their own. same time, it was learned that Paul resolution sampling only. Test tube Lauterbur had ordered a resistive magnet samples are spun at about one hundred  In February, 1974, Dr. with a bore large enough to place a human rotations per minute in order to create a Damadian was issued a patent inside. Upon delivery it was discovered stronger and clearer signal from a more for his “Apparatus and Method that the opening was too small! homogeneous sample. To put a person in for Detecting Cancer in Mike Goldsmith spent many weeks the NMR machine seemed totally Tissue". wrapping the superconducting wire into outlandish. When Dr. Damadian, during hoop shaped coils for the new machine. He his various lecture tours, mentioned his At the same time, two groups in the was worried that the joints holding the desire to build an NMR machine that was physics department of the University of wire together might be faulty. Goldsmith large enough to scan a human, it seemed as Nottingham in England were working to used an ohmmeter to check the coils, if someone from the audience always produce clear NMR images. One group, luckily all connections were good. asked, “How fast are you going to spin the led by Waldo Hinshaw and Raymond Damadian and Minkoff built the cryostats patient?” Needless to say, he had few Andrew, the other group, led by Peter to contain the liquid helium and nitrogen. supporters at this time. Mansfield. Hinshaw evolved his own Each container was about 10 feet tall and Writing to President Nixon, after many scanning technique, thinking that weighed over a ton. Many long hours were attempts to obtain grant money for Lauterbur’s was too complicated. Instead spent in the lab, fearing that Lauterbur research, Damadian received a grant from he used oscillating gradients to isolate a would be the first to scan a human. At the National Institute of Health (NIH) in point or plane in space. This way Hinshaw times they would work through the night 1971, to continue his work. He proposed to was able to focus the scan on one area, and home was only a place to sleep. use whole body scanning by NMR for wiping out all other signals in the sample. The doughnut-shaped dewar (cryostat) medical diagnosis in a patent application in Images of a lemon and a human wrist were took nearly a year to construct. Leaks were 1972. eventually produced employing this a major problem, even a hole the size of a During experimentation, Dr. Damadian method. molecule had to be sealed; cryogen could found that cancerous tissue had a leak right through the pores of the relaxation time two to three times that of  By February 1976, Dr. aluminum. The entire structure had to be normal tissue. Being an outsider to the Damadian, using his FONAR covered by the welding torch. Minkoff well-entrenched NMR community, method - field focusing nuclear learned to weld through a three-part series Damadian felt that people, like Dr. Paul magnetic resonance - was able featured in a science magazine. Lauterbur were trying to subvert his efforts to scan the interior of a live The completed structure weighed close to obtain funding for research. Damadian mouse with the NMR signal. to a thousand pounds, requiring a block found an ally in his Brother-in-law who and tackle to hoist it in position. With spent long hours trying to raise money for In 1974, Mansfield discovered a method time ticking away Dr. Damadian decided Dr. Damadian to continue when he was to image a “selective slice” of tissue. He to junk the second dewar even though the almost depleted of funds. had scanned chicken legs (dead) and later magnet would not have as controllable a In February, 1974, Dr. Damadian was produced scans of a human finger with field. issued a patent for his “Apparatus and amazing detail. Another group, EMI, in In a quest for much needed funding, Dr. Method for Detecting Cancer in Tissue". Aberdeen, Scotland also had ongoing Damadian attempted to meet with By February 1976, Dr. Damadian, using research in NMR imaging. President-elect, Jimmy Carter, in Plains, his FONAR method - field focusing The design of a human NMR scanner Georgia. Unfortunately, the President was nuclear magnetic resonance - was able to slowly began to take form. The heart of the not approachable at that time. Just when scan the interior of a live mouse with the machine was a very large magnet. With the the funds were running out, a Benefactor NMR signal. Many such experiments were help of the Physics Department of supplied enough money to finish the performed using mice. The first one was Brookhaven National Laboratory, Dr. project. called “Pioneer Mouse”. Coils were placed Damadian received information on the (Cont. on page 3)

2 Damadian (cont. from page 2) also showed an interest though nothing report back in 2007. The Committee ever came of it. questioned, "Why are there unregulated With the new funding, the large storage modalities of the imaging profession?" container and dewar were completed. Still,  On July 3, 1977, the first Attended by all concerned parties, the small leaks were costing thousands a week human image from the issue addressed was the consideration of a in lost liquid helium. “Indomitable” was obtained. state license for all medical imaging A coil to wrap around the patient was It was a cross-section of Larry modalities that were not licensed at the still needed to complete the machine. They Minkoff’s chest. time. Promoted strongly by the X-Ray found that the equations for determining (RT) lobby, and all of its national and local capacitors were faulty. While they were In early 1978 Dr. Damadian formed the entities, the original proposed license accurate enough to build very small FONAR Corporation. Damadian and his would have required all medical imaging antennas, they were useless for anything Brother-in-law set out to raise funds for the technologists be educated, certified and larger. Goldsmith built fifteen coils before new company. Slowly, investors took licensed as an X-ray tech (RT) to obtain a an adequate one was constructed. He stock in the company. Dr. Damadian license. couldn’t understand why a fourteen-inch decided that the company would build To be specific, the original license coil worked and a sixteen-inch coil NMR machines using a permanent magnet proposal meant that if your specialty is wouldn’t. instead of a superconducting type. He felt MRI, Ultrasound, Nuclear Medicine or X- When completed, the machine was that superconducting magnets would be ray, you would be required to complete an christened “Indomitable”, for all the too much trouble for the hospitals to bother X-ray technologist program (usually 2 work and unyielding spirit it took to build. with. Both liquid helium and liquid years) prior to being eligible for an Oregon It resembled the slowly turning wheel at an nitrogen would have to be on constant license. amusement park that turned while people supply, a very costly prospect. Realizing that, like most states, their tried to walk through. Across the center of (Cont. on page 4) laws were thirty (30) years obsolete, and the wheel was a wooden plank with the the Oregon Statutes and Administrative coil attached. Rules governing the OBRT have not kept Turning the magnet on, Damadian up with the advances in medical imaging noticed that its field would drift, so the technology. The Board members were power was reduced. Tubs of water encouraged by Rep. Greenlick, Chair of containing nickel chloride were used as E-mail: the House Health Care Committee, to use phantoms to test for a detectable signal. A [email protected] public sessions to prepare for resubmitting turkey (dead) was then tested and its the bill for the 2009 Legislative Session. interior was clearly outlined. Next Dr. Thanks to Aaron Carroll and William Damadian tried to scan himself. As he sat Web: www.armrit.org (Bill) Woodward, ARMRIT certified MRI in the machine, it was turned on but techs working in the state of Oregon, and a nothing happened. The antenna had to be large contingent of Ultrasound techs adjusted due to too much interference in ARMRIT certified by the American Registry of Diagnostic Medical Sonographers the signal-to-noise ratio. 8815 Commonwealth Blvd. On July 3, 1977, the first human image (ARDMS), the committee was educated from the “Indomitable” was obtained. It Bellerose, NY 11426 and informed of the realities of today's was a cross-section of Larry Minkoff’s medical imaging specialties. This was an chest. The image revealed the heart, lungs, eye opener for the committee as both vertebrae and musculature. Damadian’s groups represented modalities employing team was overjoyed! Wine was opened for non-ionizing radiation. the occasion. ARMRIT Damadian wrote “Fantastic success, first “Because MRI is a Specialty”  ...the original license proposal human image, completed in amazing meant that if your specialty is detail.” This first scan required Minkoff to MRI, Ultrasound, Nuclear be moved over sixty positions with 20 to Oregon to License MRI Techs, Medicine or X-ray, you would 30 signals taken from each position. These ARMRIT Included (cont. from page 1) be required to complete an X- signals were then averaged and produced ray technologist program an image on the screen. The result of the culmination of many (usually 2 years) prior to being Dr. Damadian quickly called a news steps leading to a fair decision recognizing eligible for an Oregon license. conference. Congratulatory telegrams each medical imaging modality as a poured in from all over the world. Among separate and distinct specialty. These This process has also led to a change in them were messages from Purcell and steps, beginning with "Open Public the Oregon Board of Radiologic Mansfield. However, Damadian’s team Technology (OBRT), which consisted of had little time to savor the triumph. The  Oregon Board of Medical only Radiography professionals. Newly next hurdle was to lower the time needed Imaging has included ARMRIT changed to the Oregon Board of Medical to produce an image. A major problem was certification as a requirement to Imaging (OBMI) which consists of, "One the signal-to-noise ratio. be eligible for a Medical of each type of subspecialty from each Throughout the fall of 1977 and early Imaging Technologist License medical imaging modality, one physician 1978, the time it took to produce a scan to practice MRI Technology. from each type of subspecialty which was brought down from hours to just 38 employs medical imaging, and two public minutes. A representative from General Meetings" held in October 2005, and members". Aaron Carroll, ARMRIT Electric went to see the “Indomitable” and January, March, and April 2006, to address certified MRI tech, is a member of this soon after, word was that GE was building questions posed by Senator Avel Gordly of newly formed body. their own scanner. Johnson and Johnson the Ways and Means Committee, and to (Cont. on page 4)

3 Damadian (cont. from page 3) interesting and will set an interesting legal to building a great working partnership precedent for the MRI field. with you and your staff in the future". In the latter part of 1978, Damadian Once scorned by the scientific completed the design of his first permanent community, Magnetic Resonance Imaging,  Awarded by the State of Oregon magnet for an MRI machine, christened pioneered by Dr. Damadian has become Board of Medical Imaging, the “Jonah”. At five hundred gauss (0.05T) it the most precise imaging modality in the new license states, "Practice of was the first practical permanent magnet diagnosis of pathology of the brain, spine, Magnetic Resonance Imaging" for imaging. In order to sell this model, heart, abdominal and pelvic areas, etc... Damadian knew he had to make it more Indeed, it can be safely stated that MRI is Again, to the fair minded Oregon aesthetically pleasing. the internal imaging breakthrough of the authorities, our ARMRIT MRI techs, An Italian sculptor was hired to design century and the benefit of non-ionizing Aaron Carroll and Bill Woodward, and the the shell as Dr. Damadian was impressed radiation is immeasurable. Ultrasound techs residing and working in since he toured Italy. After refinements to It is surely the greatest advance in the Oregon, Thank You All. the electrical system, by early 1980 the medical imaging field since the invention QED 80 was completed, the first of the X-Ray machine one hundred years James F. Coffin, President commercial MRI scanner. ago. As Henry Ford revolutionized the In the spring of 1980, the QED 80 was transportation industry nearly eighty years CONTINUING MEDICAL shown to the world at a radiologic show. ago, likewise, Dr. Raymond Damadian EDUCATION (CME) REQUIREMENT Four prototypes were built and by the end revolutionized the medical imaging field in Bellerose, NY of the year were installed in Cleveland, our time. He is truly the “Henry Ford of Mexico, Italy and Japan. Since the FDA MRI”. had not yet approved the scanner, they Registry Active Certified MRI were only used for clinical testing at this Thomas V. Doherty Technologists: point. A year later, at another radiological All ARMRIT Certified MRI Technologists are required to renew their certification show, a competitor presented their new Oregon to License MRI Techs, before expiration and must submit machine, a superconductor at over three ARMRIT Included (cont. from page 3) evidence of six (6) CME credits per year thousand gauss (0.3T). The clarity of the for a total of twelve (12) CME credits in pictures it produced had far better signal- The State of Oregon is an example for all MRI Technology as awarded by the AMA, to-noise ratio (SNR). Damadian knew he states considering updating their current ACCME, AHRA, or other material found had to build a permanent machine of at standards and legislation for the medical suitable by the board of directors least 0.3Tesla. Since a permanent magnet imaging modalities. Oregon authorities, in of this size had not been built before, a power point presentation, made clear New Certified MRI Technologists: Damadian's team went back to burning the their expectations: New ARMRIT Certified MRI Techs are midnight oil. The new magnet weighed not required to submit evidence of CME approximately 100 Tons (200,000 lbs.). 1) Protection of the public from credits until their third calendar year of Called the BETA 3000, FONAR’s unqualified or unethical certificate renewal, including the year the latest machine was given critical acclaim healthcare providers. Certified Tech successfully completed the for its high resolution images. Orders examination. began to arrive on a steady basis. At this 2) Limiting harm from diagnostic time, the magnetic resonance imaging imaging devices. CME Topics: industry expanded rapidly with about Continuing medical education credits must thirteen different manufacturers. Dr. 3) Increased public confidence in be derived from topics related to Magnetic Damadian considered them all to be medical imaging practitioners Resonance Imaging technology and/or infringing on his patent since he had not throughout Oregon. MRI patient care and safety. given them license to use his technology.

While most companies produced At the same time, made clear what they Note: Subjects other than MRI will not superconducting magnets, FONAR alone intended to avoid : be accepted. was producing the permanent type. In 1983, FONAR introduced a mobile A. Multiple agency licenses for scanner, installed on a moving van size persons working in more than General Information truck. Designed with a minimum fringe one modality. field to avoid elaborate shielding To update your contact information , send precautions which would be very B. Legislating anyone out of their an e-mail to: expensive. job. [email protected]

 MRI is the internal imaging C. Decreasing availability of To Verify a Tech's Certification: breakthrough of the century services in rural areas. E-mail a request to [email protected] and the benefit of non-ionizing Provide Full Name & Registry Number. radiation is immeasurable . Awarded by the State of Oregon Board of Medical Imaging, the new license states, Renew your CPR/BLS on-line visit Today, FONAR Corporation "Practice of Magnetic Resonance Imaging" www.armrit.org and Click on the: headquarters in Melville, New York has (see page 5). In a letter in June 2010 to Pro CPR Box supplied MRI scanners worldwide. Dr. James F. Coffin, ARMRIT President (see Damadian is still in the ring fighting the page 6), the Executive Director of the, then competition on patent infringement. The OBRT stated "We are pleased to be able to outcome of these cases should be very license your registrants and look forward

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6 Agenda: ARMRIT 2010: 5th Annual Meeting & Seminar - October 21-23 Stirling Club-Turnberry Place, 2827 Paradise Road, Las Vegas, NV 89109

Thurs. Oct. 21: 7:00-9:00 pm: Registration & Cocktail Reception Fri. Oct. 22: 7:30–8:45 am: Registration & Breakfast Provided 8:45–9:00 am: Opening Remarks - Wilfrido M. Sy, MD Chairman & Executive Director Welcome & Overview - James F. Coffin, President

PLENARY SESSION: Friday Oct. 22 Moderator: Wilfrido M. Sy, MD Time: 9:00am Keynote - "The History and Genesis of MRI, A Machine Called Indomitable" Raymond V. Damadian, MD President & CEO, Fonar Corporation, Melville, NY Time: 10:00am "CMS Diagnostic Imaging Accreditation Requirements" Leonard Lucey, Senior Director, American College of Radiology Moderator: Albert D. Cayton, MD Time: 11:00am "EPI: Part I - MR’s Great Enabler: Understanding the Basics" Thomas Schrack, ARMRIT, Mgr MR Educ./Tech. Development Fairfax Rad. Consults., PC

Noon: Lunch Provided

Time: 1:00pm "EPI: Part II - MR’s Great Enabler: "Applications and Implication" Thomas Schrack, ARMRIT, Mgr MR Educ./Tech. Development Fairfax Rad. Consults., PC Time: 2:00pm "Functional MRI (fMRI)" Stephen M. Dashnaw, ARMRIT, Columbia University, NY, NY Time: 3:00pm "MRI of Lower Extremity Sports Injuries", Sean Beaty, MD, Rad. Specialists, Ltd., LV, NV

Saturday Oct. 23 7:30–9:00am: Registration & Breakfast Provided

Moderator: Paul Heubeck

Time: 9:00am “MRI-PET Fusion Imaging”, William J. O’Connell, Dr.PH, Columbia University Medical Ctr., NY Time: 10:00am “MRI & PET-Spect”, Karin Knesaurek, Ph.D., Mount Sinai Medical Center of New York Time: 11:00am “Breast Imaging & Biopsy", Tim Smith, ARMRIT, Providence Health Systems, Portland, OR

Noon: Lunch Provided

Moderator: William J. O’Connell, Dr.PH, DABR

Time: 1:00pm "MR Cholangio-Pancreatography", Timothy Troncale, RT(R)(MR), ARMRIT, CPI, Alliance Imaging, CA Time: 2:00pm "Cardiac MRI: Advantages & Pitfalls of 3T Cardiac Imaging / Plane Alignment, A Clinical Perspective", William J. Woodward, ARMRIT Oregon Health Sciences University Time: 3:00pm "New Techniques and Works in Progress, William J. Woodward, ARMRIT, Oregon Health Sci. Univ. Time: 3:45 pm: Closing Remarks - James F. Coffin, President

Accreditation: this course meets all criteria and has been approved by A HRA : 12 Category A Continuing Education Credits.

Visit www.armrit.org and Click on the Acteva Box! 7 For Accommodations at the World Famous Las Vegas Hilton thru September 21, 2010. Call Directly at: 800-635-7711 between 6:00am to 12am Daily. Ask for Rooms for the ARMRIT group – Rates: Premium Rooms $99 per night. Single or Double.

Or

For More Affordable Reservations at the SAHARA Hotel and Casino: Rooms $32 Thursday and $67 Friday & Saturday Per Night Suites $70 Thursday and $105 Friday & Saturday Per Night Thru October 1 st only!!!

For reservations call the Sahara Hotel toll free number: 888-696-2121

State that you are with ARMRIT 2010 . When making the reservations, request for a higher floor at the 12th floor or above, as these are deemed the preferable rooms.

All registrants are encouraged to book early for preferred accommodations!

8 ARMRIT 2010 - REGISTRATION FORM

Name ARMRIT Certificate# / Non-ARMRIT

Address

City, State/Province, Zip/Postal Code, Country

Telephone Fax

E-mail

Emergency Contact Name and Telephone

*Registration Fees: July 1, 2010 – On site

ARMRIT Tech (Oct. 21 - 23) ______$400 __ _ $______

ARMRIT Tech Oct. 22 Only! ______$225 __ _ $______

ARMRIT Tech Oct. 23 Only! ______$225 __ _ $______

Non-ARMRIT (Oct. 21 - 23) ______$425 ___ _ _$______

Non-ARMRIT Oct. 22 Only! ______$250 ___ _ _$______

Non-ARMRIT Oct. 23 Only! ______$250 ___ _ _$______

*Non-Attendee Spouse or Guest for Cocktail Reception – Oct. 21 $75______$______

Total $ ______Payment Options: Check ___Money Order___ Check or MO payable to: ARMRIT

Pay by Credit Card: (check one) Master Card ____ Visa ____ American Express____ Discover _____

Card Number: ______Expiration Date: ______

Name of Cardholder (Print): ______

Authorized Signature: ______Date: ______

Mail Registration Form To: 8815 Commonwealth Blvd. or Fax: 718-347-8691 Bellerose, NY 11426

SPECIAL NEEDS: If you have any special needs or dietary requirements, please let us know so that we may do our best to accommodate you. Contact ARMRIT at 718-347-8690 or e-mail [email protected]

Cancellation Policy: A refund (less a $100 administrative fee) will be processed for any cancellation made in writing prior to September 1, 2010. No refunds after September 1, 2010

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