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Herring 2000: Expectations for a New Millennium
Registration Form |
Name:____________________________________________________________
Affiliation:_____________________________________________________
Address:_________________________________________________________
City:_______________________________ State/Province:_____________
Country:_______________________ Zip/Postal Code:_________________
Phone:____________________ E-mail:_______________________________
REGISTRATION FEE (check appropriate amount):
[ ] $175.00 until January 15 [ ] $200.00 after January 15
Herring2000 collectible T-shirt:
Number of each size: M ___ L ___ XL ___
Total number of shirts: _____ at $12.00* US each = _______
* $15.00 after Jan. 15 and at symposium
Registration $________
T-shirts $________
Total $________
PAYMENT
[ ] Check payable to University of Alaska Sea Grant enclosed
[ ] Charge my VISA or MasterCard account
Card number: __________________________________ Expires: ________
Signature:_____________________ Printed Name:____________________
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| Please fax or mail form to:
Alaska Sea Grant College Program, University of Alaska Fairbanks
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