NOAO >   Meetings >   Fred Gillett Symposium >   Registration Form

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National Optical Astronomy Observatory

Registration Form (Fred Gillett Symposium: Apr. 11 to Apr. 14, 2002)

Registration Forms are due by Mar 27, 2002

Note: Required fields are designated with an *.

Registration Information
First Name: * Last Name: * Name on badge:
Institution/Company: *
Address: *
City: * State/Province: * Zip/Postal Code: *
Country: *
Phone number: * Fax: E-mail: *
Spouse/Guest Name (if attending):

Hotel Information
Hotel Arrival Date (YYYY-MM-DD): Departure Date (YYYY-MM-DD):
Extended Stay
Early Arrival Date (YYYY-MM-DD):
Delayed
Departure Date (YYYY-MM-DD):
Credit card required to secure rooms, Rate/night, for early arrival and delayed departures.
Hotel:
Smoking Preference: Bed Preference:
Room Share Will share a room with:
Please find a roommate I am:
Special Needs:

Travel Information
I will arrive at:
Arrival Date (YYYY-MM-DD): Arrival No (e.g. Airline/Flight): Time:
Departing Date (YYYY-MM-DD): Departure No (e.g. Airline/Flight): Time:

Transportation Information
I am happy to rent a vehicle if asked to:
Questions? Contact Kathy English at (520) 318-8135 or by e-mail: kenglish@noao.edu

NOAO >   Meetings >   Fred Gillett Symposium >   Registration Form

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