Registration

Please use the form below to register for the conference by November 7, 2005. Should you choose to participate in certain special events (indicated below), you may pay in advance via check or at the door.

Checks, made payable to WPI, should be sent to:

Mathematical Sciences Department
Attn: Colleen Lewis
WPI
100 Institute Road
Worcester MA, 01609-2280

First Name:
Middle Name/Initial:
Last Name:
College/University:
Address 1:
Address 2:
City:
State:
Country:
Zip:
Phone:
Fax:
E-mail:
Special Events:	Reception on Thursday Evening, 11/17, $0.00 per person for person(s) Lunch on Friday, 11/18, $15.00 per person for person(s) Banquet on Friday, 11/18, $40.00 per person for person(s) Lunch on Saturday, 11/19, $15.00 per person for person(s)
Guest:
Special Needs:
Additional Comments/Questions:

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Last modified: Mar 31, 2009, 11:39 EDT