Regular Mail or FAX - Registration Form

Fall Meeting of the Illinois Section of AAPT, Oct. 10-11, 2003, Illinois State University, Normal, 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   $18  
Student registration   $ 5  
Illinois section dues   $ 5  
Workshop  W1 - "Cosmic Ray Detection Network", Friday 9:00-12:00   free  
Workshop  W2 - "Simple Experiments in Physics", Friday 9:00-12:00   free  
Workshop  W3 - "What's a Good Question...", Friday 10:00-12:00   free  
* Friday evening banquet

The deadline for meal
reservation is past.

* Saturday noon lunch. Circle your choice of sandwich:  turkey, ham, roast beef, veggie
Total fees  

* The meals are available only to those who have registered by the October 6 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:  Carl Wenning, Physics Department, Illinois State University, 322 Moulton Hall, Normal, IL 61790-4560.  FAX: 309-438-5413.

Last update: October 6, 2003

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