NOAA NESDIS/CREST REGISTRATION FORM
Modelling and
Measurement of Aerosols
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Please
print and return by regular mail or fax.
Please
note that this is how you will be indicated on your badge and the list of
participants.
Date: June
14-16, 2004
Place: Room
401, Physics Department, University of Maryland, Baltimore County
1. Participant information
Title: 
Prof. Dr. Mr. Ms. Mrs. other:_________________________
Family name:____________________________ First
name:___________________________
Organization:________________________________________________________________
Address
1:______________________________________________________________________
Address
2:______________________________________________________________________
Zip
Code:________________ City:________________________________ State:________
Telephone:__________________________________________________________________
Fax:_____________________________
E-mail:_____________________________________
2. Symposium Fee
The Symposium fee of $100 US includes participation in the conference, copy of the conference CD, morning and afternoon coffee and snacks, parking fees, a ticket to the barbeque on Monday evening, June 14.
Student scholarships to cover the Symposium fee and travel are available. If you are a student and wish to be considered for a scholarship, please contact Fran Holt directly: Fran.Holt@noaa.gov (Fax # : 301-763-8108) and indicate your affiliation, your advisor, and estimated expenses.
I will
attend the barbeque
yes
no
Accompanying person at barbeque ($20)
yes
no
The barbecue will be held on the grounds of UMBC. The cost for attendees
is included in the registration fee; there is a $20 charge for guests. Please
send any dietary restrictions/concerns directly to Kevin McCann: aerosolsymposium@jcet.umbc.edu .
3.
Payment
Payment
information
Symposium fee: $
________
Barbeque (accompanying person $20) $ ________
Total
fees: $ ________
I will pay the
amount:
By credit card:
Master/Eurocard Visa American Express
Credit Card
Number :_________-________-________-________
Expiration
Date :_______/________
Name
of Cardholder :__________________________________________________________
CVC Code* :_____ _____ _____
*Please
note that you need to fill out your CVC code as well. This is a 3-figure code
on the back of your credit card following the credit card number.
Authorizing Signature:
_________________________ Date:
_____________________
By
Check (Make checks payable to "UMBC:
and the memo part of the check will be- NOAA NESDIS Symposium")
Payment at Registration
4. Parking
I will require a parking pass for Monday Tuesday Wednesday
Parking will be available in Lot 3 near the Physics Building. Parking passes can be picked up at UMBC
Parking Services (Building 25 - C,D-3 on the campus map http://www.umbc.edu/aboutumbc/campusmap/C3.html)
or will be mailed to pre-registered attendees.
5. Additional Instructions
Hotel: A limited
number of rooms are being held at the Homewood Suites at BWI until May 21,
2004. See the symposium web page (http://alg.umbc.edu/AerosolSymposium/home.htm)
for details on how to contact the hotel.
Transportation: Transportation to and from the hotel is included
in the symposium fee for attendees staying at the Homewood Suites at BWI. Details on bus times and pickups will be posted
on the website in early June.
Deadlines: Advance registration
can be faxed or mailed no later than June
6, 2004. Please use one form per person. If you should have problems
registering, please contact the symposium organizers at aerosolsymposium@jcet.umbc.edu.
Payment Information:
Registration forms must be accompanied by full payment in order to be
processed.
Incorrect
credit card numbers and declined credit are considered non payments and
registration will not take
place.
No registrations will be accepted by telephone.
Refund
policy:. The Symposium Office
should be notified of cancellations in writing. If the Symposium Office
receives cancellations before June 6, 2004, the total conference fee will be
refunded, less $25 administration costs. After June 6, 2004, no refunds will be
made. Please note that refunds will only be made after the conference. "No shows" are
non-refundable and are liable for the full registration. If you cannot attend,
you may send a substitute person. The original registrant must submit a written
authorization for such a change.
Confirmation: Please
allow up to 10 days for mailed confirmation of your registration.
By sending
in this registration form, I acknowledge that I commit myself to the immediate
payment of the full conference fee. I have taken notice of the cancellation
terms on this form.
Date (MM/DD/YYYY):_____/_____/_________
Signature:_______________________________________
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Return address: NOAA NESDIS/CREST
Symposium Joint Center for
Earth Systems Technology University of
Maryland, Baltimore County 1000 Hilltop
Circle Baltimore, MD
21250 Tel:
410-455-6362 Fax: 410-455-1291 E-mail: aerosolsymposium@jcet.umbc.edu
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PDF version of Registration form
DOC version of Registration
Form