Regular Mail or FAX - Registration Form

Spring Meeting of the Illinois and Chicago Sections of AAPT
April 14-15, 2000, University of Illinois, Urbana-Champaign, 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.

+ We are pleased that the Provost of UIUC is providing supplementary funds to cover some of the expenses for registration, workshops, the banquet, the box lunches, and travel for Dr. Tananbaum.

* The Friday banquet and the Saturday noon box lunch are available only to those who have registered by the April 7 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:

Last update: March 12, 2000