REGISTRATION FORM
SINS "Small Ionized and Neutral Structures in the Diffuse ISM"
May 21-24, 2006
Socorro, New Mexico USA

Deadline for Registration: May 01, 2006
Cost of Registration: $120.00

 

NAME:
AFFILIATION:
E-MAIL ADDRESS:
FAX NUMBER:
PHONE NUMBER:

POSTAL ADDRESS:

TRAVEL INFORMATION
Check one:
   I have made my own transportation arrangement and will arrive in Socorro by rental car or other
         commercial transport.
  I will fly in to Albuquerque airport and take advantage of NRAO transport to Socorro.

Arrival Flight Information:
ARRIVAL DATE:
ARRIVAL TIME:  a.m. p.m.
AIRLINE & FLIGHT NUMBER: 

Departure Flight Information
DEPARTURE DATE: 
DEPARTURE TIME:   a.m. p.m.
AIRLINE & FLIGHT NUMBER: 

If your want to register early, but your flight information is not yet available, you may send your airline information by a separate e-mail to tromero@nrao.edu .

LODGING
I have reserved a room at:
Holiday Inn Express
NRAO Guest House
Other

REGISTRATION FEE
Please select a payment option:
Credit Card  [Only VISA or MASTERCARD Accepted]
    If you have indicated that you are paying with a credit card, a fax form will automatically be generated for    you to print, fill in credit card information and fax directly back to us.
Personal check  Personal check payable to NRAO (US$ only, drawn on a US bank) and mail to:
   Attention: Terry Romero
   NRAO
   PO BOX O
   Socorro, NM 87801

DIETARY
Please indicate any special dietary requirements for the conference dinner.
None:
Vegetarian:
Other:   Please specify:
Allergy: Please specify:

TOUR OF VLA SITE - May 24, 2006 (in afternoon on last day of conference)
Please indicate if you wish to join the tour.
Yes No

Would you like to receive an e-mail confirmation of this submission?
Yes No

Modified by Terry Romero tromero@nrao.edu on Friday, 26-Sep-2008 11:48:55 MDT