Registration Form - Regular Mail

Fall Meeting of the Illinois Section of the AAPT
October 12-13, 2007 - Lincoln Land Community College, Springfield, Illinois

Name:  ______________________________________________________________________________

Address - line 1:  ______________________________________________________________________

Address - line 2:  ______________________________________________________________________

City, State ZIP: _______________________________________________________________________

E-mail:  _____________________________________________________________________________

Institution (to appear on your name tag):  __________________________________________________

I would like to do a "Take Five" on ___ Friday afternoon,  ___ Saturday morning, ___ either day.

The title of my Take Five presentation is: __________________________________________________

I will be bringing an item for WITHIT (What in the heck is it?) on ___ Friday, ___ Saturday, ___ either day.
Description Number Unit cost Amount
Faculty registration   $20  
Student registration   $ 5  
Illinois section dues   $ 5  

Please indicate if you wish to register for a workshop.
Note:  W1, W2 and W3 are at the same time so you can only register for one of them.
Workshop W1. "New Developments in MBL Tools" - Friday 10:00-12:00      
Workshop W2. "A Natural – Nuclear Physics, Nuclear War" - 10:00-12:00      
Workshop W2. Cracker Barrel: "Physics Teacher Candidate Preparation" - 10:00-12:00      
* Friday evening buffet banquet.  The entrees are chicken, pork and vegetable lasagna (upon request).   $18  
* Saturday noon lunch. Circle your choice of sandwich: 1. Ham & Swiss Cheese, 2. Turkey and Provolone Cheese, 3. Roast Beef and Cheddar Cheese, 4. Chicken Salad, 5. Tuna Salad, 6. Veggie Delight.  All lunches come with chips, cookie, apple, and soda. The "Veggie Delight" includes cucumber, tomato, avocado & havarti cheese.   $ 7  

Total fees

  

* The meals are available only to those who have registered by the October 5 deadline.  Please make your check payable to ISAAPT and include it with the registration sent via US Mail.  If registering online, the registration amount will be due upon arrival.  Please return this registration form to:  Dave Sykes, Lincoln Land Community College, 5250 Shepherd Road, Springfield, IL 62794-9256.

Last update: September 5, 2007

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