Synthesis Imaging Workshop Registration

Please fill out the form and hit the "Register for Workshop" button, below. However you are not fully registered until you pay the registration fee. See the main web page for information on how to pay the fee, which is $200 until May 1st and $250 thereafter. Send questions about this form to Antonette Romero or Amy Mioduszewski. Fields marked with an * are required.

First Name*
Last Name*
Name on Badge (if different)

Email Address*
Phone Number*

Street Address*

City*
State		Zip
Country*

Affiliation Type	NRAO Employee All Others
Affiliation Name*

Professional Status*

There will be two days of tutorials (June 11 and 15), please select your preferences
June 11 Tutorial
June 15 Tutorial

I would like wireless in lecture hall

AIPS Experience	I have some experience using AIPS I have never before used AIPS
CASA Experience	I have some experience using CASA I have never before used CASA

Please indicate any special dietary requirements for the Summer School Dinner

Travel Plan	My travel plans are unknown at this time I will arrive in Socorro by car I will fly in to Albuquerque and use NRAO transport to Socorro
Arrival Information		Departure Information
Date		Date
Time		Time
Flight		Flight

Please Indicate any Motel/Hotel reservations you've made
Motel Name