| (To register on-line go to http://www.asp.org/asp2003/ | This form is for mail-in registration only |
| REGISTRATION FORM FOR THE TWENTY-SIXTH ASP MEETING | ||||||
| CALGARY, ALBERTA, CANADA JULY 30th - AUG 2nd 2003 | ||||||
| NAME (as it will appear on name tag) | _________________________________________________________ | |||||
| ADDRESS: | _________________________________________________________
_________________________________________________________ |
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| AFFILIATION (for name tag): | _________________________________________________________ | |||||
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| REGISTRATION FEES (fees are NOT refundable) | ||||||
| SPECIAL NOTE: The registration fee includes chuck-wagon breakfasts, snacks during receptions and posters sessions, lunches from Thursday to Saturday, and the closing banquet. Note that fees increase after March 1, 2003. | ||||||
| MEMBERSHIP STATUS | FEB 1-MAR 1 2003 | AFTER MAR 1 | [ON SITE] | |||
| Regular member | $160.00 q | $210.00 q | [$260] | |||
| Student member* | $105.00 q | $125.00 q | [$145] | |||
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* Must be a current student member of ASP Faculty Advisor's Signature _________________________________________________________ |
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| Non-Member | $210 q | $255 q | [$300] | |||
| Guest (attends social events only)** | $95.00 q | $115.00 q | [$135] | |||
| (use guest registration form) | ||||||
| REGISTRATION PAYMENT OPTIONS: CHOOSE ONE | ||||||
| CHECK OR MONEY ORDER (make checks payable to ASP) q CREDIT CARD q | ||||||
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q Visa q Mastercard q Discover |
Card Number ______________________________________ Exp Date ___________ |
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| Authorizing Signature: | _________________________________________________________ | |||||
| Volutary contribution to cover credit card processing fees (3.5%) | $__________ | |||||
| Total charge to credit card | $__________ | |||||
| PAYMENT ENCLOSED: | Reg. Fee | + Guest = | $__________ | |||
| ARE YOU SUBMITTING AN ABSTACT AS PRESENTING AUTHOR? q YES q NO | ||||||
| ABSTRACT TITLE: | _________________________________________________________ | |||||
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