Registration Form
CLASS SIZE IS LIMITED, SO REGISTRATION SHOULD BE MADE AS SOON AS POSSIBLE.
ENROLL TODAY BY COMPLETING THE FORM BELOW. CLIP IT AND MAIL WITH PAYMENT
TO:
Rocky Mountain Mathematica
c/o Ed Packel
730 Highview Terrace
Lake Forest, IL 60045-3229
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Rocky Mountain Mathematica Registration Form July 11 - 16, 2010
One form per person (duplicate form as necessary). Please type or print
in the spaces below.
Last Name ___________________________ First Name ____________________
Affiliation (as it will appear on name badge)________________________
Mailing Address _____________________________________ Home or Office?
City _______________________________ State/Province _________________
ZIP/Postal Code ____________________ Country (if not U.S.) ________
Telephone __________________________ Fax ____________________________
E-mail address ______________________________________________________
Computer Information:
********** Will Mathematica (Version 6 or 7) be already installed on your computer? YES _______ or NO _______
********** Type of operating system: Windows __________ or Macintosh __________
One registration fee for the introductory _____ or intermediate _____ course
($825 for new registrants; $725 for returnees; an additional $50 if received after June 1) $ ___________
Wednesday, July 14, group dinner buffet including family and friends ($29.00
per person) _____ x $29.00 = $ ___________
Enclose check (U.S. funds) payable to the Rocky Mountain Mathematica -- Total enclosed $ ___________
Confirmation and additional detailed information will be sent to you.
Cancellation Policy Substitutions may be made at any time. Cancellations
received by May 15 are fully refundable. After that date, there will be
a $100.00 cancellation fee.
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