APS NEW YORK STATE SECTION FALL 2000 SYMPOSIUM

REGISTRATION FORM

Please return to:

Pat Meider or

Marlene Kowalski

Department of Physics

SUNY at Buffalo

Buffalo, NY 14260-1500

Phone: (716) 645-2017

Fax: (716) 645-2507

Name:

________________________________________________________________

Last

First

Address:

________________________________________________________________

________________________________________________________________

City:

______________________________

State__________

Zip__________

Affiliation:

________________________________________________________________

(NYSS, AAPT, APS, etc.)

________

Pre-registration for NYS-APS members (deadline October 6):

No Fee

________

Pre-registration for non NYS-APS members (deadline October 6): $ 10.00

________

Late Registration: $ 15.00 NYS-APS members, $ 15.00 for non NYS-APS members

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Students:

No Fee

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Banquet at Marriott Hotel, Friday, 10/20

(NOTE: You must pre-register for the banquet)

Please indicate entrée choice:

________ Pasta Primavera (Vegetarian)

$ 21.00

________ Roast Prime Rib of Beef with Natural Au Jus

$ 26.00

________ Chicken Wellington in Mushrooms and Onion

$ 24.00

________

Donation for student support (optional)

_______

TOTAL

(Checks payable to "NYSS-APS")

Special Needs: _________________________________________________________________

_________________________________________________________________

Fees must accompany Registration Form.

Directions to Amherst and a campus map will be mailed with Registration confirmation and are also available on the home page at

http://www.physics.buffalo.edu/aps-nyss/