Online Registration Form

 Fall Meeting of the Illinois and Chicago Sections of the AAPT
October 26-27, 2012 - Joliet Junior College, Joliet, Illinois
Note:  It is convenient to move from one box to the next with the Tab key.
Measuring G
First name   Last name  
Mailing address - line 1 
Mailing address - line 2 
City  State                              ZIP code 
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
**The Amount will be displayed after you click the Registration button.
Description   Cost **Amount
 CSAAPT

Affiliation

    
 ISAAPT    
Faculty registration - Both days

Select one

 $40  
Faculty registration - Friday $30  
Faculty registration - Saturday $20  
Student registration - Both days $10  
Student registration - Friday $7  
Student registration - Saturday $4  
Invited guest registration free  
Chicago section dues - (required for CSAAPT membership) $10  
Illinois section dues - Faculty (required for ISAAPT membership)

Dues Record

 $20  
Illinois section dues - K-12 (required for ISAAPT membership) $10  

Please indicate if you wish to register for a workshop.
W1.  Arduino Open-Source Electronics 9:30-11:30

 Friday morning

 free  
W2.  Vernier Physics Apparatus 9:30-11:30 free  
W3.  TIPERS 1:00-3:00

Saturday afternoon

 free  

Check the appropriate boxes for meal reservations.
Friday evening banquet - buffet *   Tossed Salad with 3 Dressings, Fresh Fruit Salad, Green Bean Almondine, Entrees: Baked Herb Chicken, Vegetable Lasagna, Mashed Potatoes & Gravy, Dinner Rolls and Butter, Frosted Sheet Cake (Chef's Choice), Coffee and Lemonade.

The deadline for
meal reservations
was Oct. 19.
Saturday noon box lunch *   All come with chips, a cookie, and a beverage.
Paper receipt in my folder - select one:                            Full       Total (no itemization)       None  

Total fees 

 

* The meals are available only to those who have registered by Friday, October 19.  All registration fees are due the day of the meeting.  Checks should be made payable to ISAAPT.

Confirmation:   Please check this box so the data will be recorded.
                                                      

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Last update:   October 21, 2012