Regular Mail or FAX - Registration Form

Spring Meeting of the Illinois Section of AAPT
April 7-8, 2006, Illinois Central College, East Peoria, 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: __________________________________________________

The Student Research Symposium needs a few judges. Could you help? ______________________
Those who say "yes" will be contacted in advance with instructions. Thank you.

 
Description Number Unit cost Amount
Faculty registration   $25  
K12 faculty registration   $12  
Student registration   $5  
Illinois section dues   $5  
Workshop  W1 - "Guiding Instruction and Learning with an STS Approach"

You can only select one of these.

  $2  
Workshop  W1 - "Tasks Inspired by Physics Education Research (TIPERS)"   $2  
Workshop  W2 - "Cracker Barrel Discussion - Recruitment, Preparation, and Retention of High School Physics Teachers"   free  
* Friday evening banquet. Circle your choice of entree: 1. Roast Beef, 2. Fried Chicken, 3. Mosticolli   $20  
* Saturday noon lunch. Circle your choice of sandwich:  1. Turkey, 2. Roast Beef   $7  
Total fees  
 
* The meals are available only to those who have registered by the March 31 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:  Ken Mellendorf, Illinois Central College, Math Science & Engineering, One College Drive, East Peoria, IL 61635, Phone: 309-694-5359, Fax: 309-694-5366.
 
Last update: March 8, 2006

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