Online Registration Form

Fall Meeting of the Illinois Section of AAPT
October 13-14, 2000, Southern Illinois University at Edwardsville
Edwardsville, Illinois 62026-1654
Note: Please do not put commas inside any of the boxes.
First name: Last name:
Mailing address - line 1:
Mailing address - line 2:
City: State: ZIP code:
 

Note: Include the area code; use hyphens.
Telephone: Ext: FAX:
E-mail:
Institution (to appear on your name tag):
 
I would like to do a "Take Five" (e.g. a new demo, announcement,..) :
Title for my Take Five: 
Registration Fees
Note: Please use integers and do not put dollar signs inside any of the boxes.
Description No. Unit cost Amount Choice of food
+ Faculty registration A - both days $16  
+ Faculty registration B - Friday only $10
+ Faculty registration C - Saturday only $10
+ College student registration (H. S. free) $3
Illinois section dues $5
+ Friday evening banquet* $12 Buffet meal
+ Saturday noon box lunch* $6
Total fees      

+ We are pleased that SIUE is providing supplementary funds to cover some of the expenses for registration, the banquet, and the box lunches.  Normally the banquet and social time would be $24.

* The Friday banquet and the Saturday noon box lunch are available only to those who have registered by the October 11 deadline.  All registration fees are due the day of the meeting. Checks should be made payable to ISAAPT.

Depending on your Internet connection and how busy the Web server is, there may be a short delay after you click on "Send Registration Now" and before you receive the automatic acknowledgement.

    

Webmaster: David Renneke - phrenneke@augustana.edu, (309) 794-3403
Last update: October 9, 2000