REGISTATION FORM
1995 SPRING MEETING

May 30 - June 2, Baltimore, Maryland

Mail form with payment to:
1995 Spring Meeting,
American Geophysical Union,
2000 Florida Avenue, NW,
Washington, DC 20009.

All fees are in U.S. dollars.

This form can be printed or saved electronically and mailed, faxed, or e-mailed to AGU. Please type or print clearly. To avoid duplicate charges, submit only one form per attendee. You may register electronically or by fax with credit card.

Family Name_________________  MI_____Given Name___________________
Name for Meeting Badge____________________________________________
Organization/Company _____________________________________________
Mailing Address___________________________________________________
City___________State/Province_________Zip/Postal Code_____________
Country_______________Internet E-Mail_____________________________
Telephone Number____________________Fax___________________________

Check as appropriate

___AGU Member            ___Non-member

AGU Membership Number: ________________

If you are an AGU Member, please check your primary affiliation:

AS__    G__   GP__    H__   OS__   P__
 S__   SA__   SH__   SM__    T__   V__

Check below if you are registering as a cooperating society member:

___ AMS   American Meteorological Society
___ ASP   American Society of Photogrammetry and Remote Sensing
___ ACSM  American Congress on Surveying and mapping
___ CGU   Canadian Geophysical Union
___ EGS   European Geophysical Society
___ UGM   Union Geofisica Mexicana

___ Check here if you are disabled and/or require special services.
     Attach a written description of your needs. A staff member will
     contact you to discuss measures AGU can take to accommodate you.

REGISTRATION FEES:

(Rates are only applicable if registration form along with payment is received at AGU by April 28, 1995. Late fees will automatically be charged after this date. Members of cooperating societies should register at member rates). One Day More than One Day Regular Member ____$ 90.00 ____$180.00 Student Member ____$ 35.00 ____$ 70.00 Retired Senior Member* ____$ 35.00 ____$ 70.00 Non-Member ____$110.00 ____$220.00 Student Non-Member ____$ 55.00 ____$110.00 * Age 65 or older and retired from full-time employment TOTAL REGISTRATION FEE: $______ Please check the days you plan to attend: ___ Mon ___ Tues ___ Wed ___Thur ___Fri SECTION LUNCHES: (Tuesday May 30) If you wish to attend a section lunch, check the appropriate box below and indicate the number of tickets. Events are open to all participants. ___ Atmospheric Sciences ___ Hydrology ___ Planetology ___ Seismology ___Space Physics and Aeronomy ___ Ocean Sciences $17.00 each x ____ tickets = $ _____ HONORS BANQUET: (Wednesday, May 31) $40.00 each x ____ tickets = $ _____ TOTAL AMOUNT ENCLOSED: $ _____ (Registration, Section Events, Banquet)

PAYMENT INFORMATION:

Make Checks payable to AMERICAN GEOPHYSICAL UNION By ___ check or ___ credit card. If paying by credit card, please complete the following: Name on the credit card (Please Print)______________________________ Card used (check) Visa___ Mastercard___ American Express___ Credit Card Number_______________Expiration Date__________ I authorize you to charge my credit card account for expenses associated with the 1995 Spring Meeting. Signature of card holder:____________________Date:_______________
RETURN FORM TO:
1995 Spring Meeting Fax: 1-202-328-0566 c/o American Geophysical Union Phone: 1-202-462-6900 outside the U. S. or 2000 Florida Avenue, N.W. toll free in U.S. and Canada 1-800-966-2481 Washington, DC 20009, USA e-mail: caging@agu.org
PREREGISTRATION DEADLINE: APRIL 28, 1995

Return to Meetings

AGU Home