Fall Meeting of the Illinois
and Chicago
Sections of AAPT
October 28-29, 2005, Riverside-Brookfield High School, Riverside, Illinois
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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 | ||
| K-12 faculty registration | $10 | ||
| Student registration | $ 5 | ||
| Illinois section dues | $ 5 | ||
| Chicago section dues | $ 5 | ||
| * Friday evening banquet. Circle your choice of entree: 1. chicken, 2. steak, 3. veggie fajitas | $20 | ||
| * Saturday noon lunch. Circle your choice of sandwich (turkey, ham or Italian combo) or salad | $10 | ||
| Total fees | |||
* The meals are available only to those who have registered by the October 21 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: Troy Gobble or Zak Knott, Riverside-Brookfield High School, 160 Ridgewood Road, Riverside, Illinois 60546-2408. Phone: 708-442-7500, Fax: 708-447-5570.
| Last update: October 5, 2005 |