Online Registration Form

Fall Meeting of the Illinois and Iowa Sections of AAPT
October 29-30, 1999, Augustana College, Rock Island, Illinois
Note: Please do not put commas inside any of the boxes.
First name: Last name:
Mailing address - line 1:
Mailing address - line 2:
City: State: ZIP code:
 

Note: Include the area code; use hyphens.
Telephone: Ext: FAX:
E-mail:
Institution (to appear on your name tag):
 
I would like to do a "Take Five" presentation:
Title for my Take Five: 
Registration Fees
Note: Please use integers and do not put dollar signs inside any of the boxes.
Description Number Unit cost Amount Choice of food
Faculty registration   $16    
Student registration   $5  
Illinois section dues   $5  
Iowa section dues   $5  
Workshop W1 - Fri. at 1:30 (limit 15)   free  
Workshop W2 - Fri. at 1:30 (limit 16)   $10  
Workshop W3 - Sat. at 1:00 (limit 20)
This workshop is full.		   $10  
Workshop W4 - Sat. at 1:00 (limit 15)   free  
Workshop W5 - Sat. at 1:00 (limit 20)   $10  
Friday evening banquet*   $12  
Saturday noon box lunch*   $6  
Total fees        

*The Friday banquet and the Saturday noon box lunch are available only to those who have registered by the October 22 deadline.  All registration fees are due the day of the meeting. Checks should be made payable to ISAAPT.

Depending on your Internet connection and how busy the Web server is, there may be a short delay after you click on "Send Registration Now" and before you receive the automatic acknowledgement.

    

Program chair and Webmaster: David Renneke - phrenneke@augustana.edu, (309) 794-3403
Last update: October 24, 1999