Pre-Registration Form -- Spring 2004 NES/MAA Meeting ,  June 4-5, 2004

On-line registration is NOT available.  However, you can print out this form and mail it Bruce Burdick at the address below.  Meals cannot be guaranteed unless reservations are received by May 28, 2004.  Dormitory housing on the Bristol campus cannot be guaranteed unless reservations are received by May 28, 2004.  Reservations for housing on the Portsmouth campus should be made directly with the Conference Center, not by using this Pre-Registration Form.  Also, since there is a limited amount of housing available at the Conference Center, those interested should call the Conference Center as soon as possible. 
Please type or print the information requested below.  Checks should be made to:  NES/MAA.    Mail this form so that it will arrive by  May 28   to

                Professor Bruce Burdick -- NES/MAA
                Department of Mathematics; RWU
                Bristol, RI 02809

Name:

Name for badge:

Affiliation:


Address:

 
 

Telephone:                                           E-mail:

Pre-registration Fee:
   MAA Member  ($25.00); Non-member  ($30.00)
   Student or unemployed ($10.00)                                       $_______

Meals:
   Meals will be buffet-style. 
   Check here if  you need vegetarian options ____

   Banquet Friday ($12.00 per person)                                $_______

*  Breakfast Saturday ($6.00 per person)                         $_______
    * For those NOT staying at the Conference
       Center which includes a continental breakfast.                                     

   Luncheon Saturday ($10.00 per person)                         $_______

Dormitory room on the Bristol campus
   $79.18  for a single Friday night (tax included)
   $94.16  for a double Friday night (tax included)
                                                                                                    $_______
   Roommate:___________________

 Total                                                                                          $_______

Want to attend Sat. 3:30 workshop?        Y___  N____

Will you attend Project NeXT?                Y____ N____

Are you retired?   __

Do you teach in HS?_____ in 2-yr College?_____

Return to  Spring 2004 NES/MAA Meeting - Local Arrangements Information.
Return to  Spring 2004 NES/MAA Meeting page.
Return to NES/MAA Home page
Return to NES/MAA Section Meetings Page.


E-mail:gingrichr1@southernct.edu
URL:  http://www.southernct.edu/organizations/nesmaa/registrationformspring2004.html
Revised: May 6, 2004

 "The views and opinions expressed in this page are strictly those of the page author and have not been reviewed or approved by Southern Connecticut State University."