Regular Mail or FAX - Registration Form

Fall Meeting of the Illinois Section of AAPT, October 18-19, 2002, Millikin University, Decatur, Illinois

Name:  ________________________________________________________________

Address - line 1:  _________________________________________________________

Address - line 2:  _________________________________________________________

City, State ZIP: __________________________________________________________

Telephone: (______)_______________ Ext.__________ FAX: (______)_____________

E-mail:  ________________________________________________________________

Institution (to appear on your name tag):  _______________________________________

I would like to do a "Take Five" (e.g. a demo, announcement,...) on ___ Fri. afternoon,  ___ Sat. morning.           

The title of my Take Five presentation is: _______________________________________________

Description Number Unit cost Amount
Faculty registration   $15  
Student registration   $ 5  
Illinois section dues   $ 5  
Workshop  W1 - "PTRA Rural Institute - Microcomputer Labs: LabPro and LoggerPro", Friday 9:00-12:00 and Saturday 1:00-4:00   free  
Workshop  W2 - "A Web-based Prep Course for Calculus Physics", 10:00-12:00   free  
* Friday evening banquet.  Please circle your choice:  (a) Chicken - $14, (b) Roast Beef - $15, or (c) Vegetarian - $13   $13,14
or 15
 
* Saturday noon box lunch.    $ 5  
Total fees  

* The meals are available only to those who have registered by the October 9 deadline.  Please make your check payable to ISAAPT and include it with the registration sent via US Mail.  If registering by FAX or online, the registration amount will be due upon arrival.  Please return this registration form to:  John Askill, Department of Physics and Astronomy, 1184 West Main Street, Millikin University, Decatur, IL 62522.  Fax: 217-362-6408

Last update: October 2, 2002

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