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2005 Newsletter - MAA Sections - Mathematical Association of ...

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<strong>2005</strong> SECTION MEETING REGISTRATION FORM<br />

First Name:_________________ M.I.:_____ Last Name:________________________________<br />

Badge Name or Nickname:______________ Affiliation:___________________________________<br />

Address:________________________________________________________________________<br />

City:___________________________________ State:_______ Zip+4:____________-________<br />

Phone Numbers: Day:_________________ Eve:_________________<br />

Fax:________________<br />

Internet address: E–mail:___________________________________________________________<br />

Web-Page URL:____________________________________________________<br />

→ Special diet: (circle one) Yes / No.<br />

Please specify: ____________________________<br />

→ Automobile parking (circle one) Yes / No<br />

Registration Fee: On/Before 15 April $ 5.00 ______<br />

After 15 April $10.00 ______<br />

Student Registration *<br />

$ 3.00 ______<br />

Luncheon:<br />

Number ____ @ $15.00 ______<br />

TOTAL:<br />

* Registration and lunch fee waived for students presenting papers.<br />

1.7475645946331821906362120355443974034851614366247417581528253507650406235327611798907583626946078899308325815387537105932820299441838280130369330021565993632823766071722975686592380371672038104<br />

Copy this form and make payment with check made payable to The <strong>MAA</strong>. Do not send<br />

cash. Mail completed form with payment to:<br />

Dean Nataro<br />

Department <strong>of</strong> Mathematics<br />

Nassau Community College<br />

Garden City, NY 11530-6793<br />

10

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