Registration Form

NNN99 Workshop

September 23-25, 1999, SUNY at Stony Brook

PERSONAL INFORMATION:
 Name as it should appear on name badge:

   First: ___________________   Last: ______________________________

   Affiliation: _________________________________________________________________ 

 Mailing Address:

   Institution: _____________________________

   Street: ______________________________________________________________________

   City:   ___________________________  State: _________  Postal/Zip Code: _______

   Country:   ________________________

   Day Phone: ________________________  Fax: ________________________ 

   Email:     _______________________________________________________


DAILY TRANSPORTATION INFORMATION:

 Daily transportation will be provided at no cost between the Holiday Inn Express 

 and the campus.

 Intend to use this service? ___Yes   ___No


PARKING:

 Parking permit needed? ___Yes  ___No


COMPANION INFORMATION:

 Will you be accompanied by companions? ___Yes ___No


FEES FOR PARTICIPANTS:

  Registration:             Cost if received on or       Cost if received
                            before August 31, 1999       after August 31, 1999

  (Please circle one:)            $175                         $200

  Includes coffee breaks, welcome reception, the banquet, conference proceedings.


ADDITIONAL BANQUET TICKETS:

   COST:                       $50                           

  Number of Tickets:           ___
                            

SUNDAY THEATRE TRIP: ("Ragtime" at Ford Center for Performing Arts in Manhattan)

   Single Ticket:              $61 (Dress Circle or Orchestra seats) 

  Number of Tickets:           ___

   Single Ticket:              $33 (2nd Balcony seats)

  Number of Tickets:           ___

  (Subject to Availability).

 
TOTAL:

   Please sum all the above amounts:       Registration Fee:     $ _________      
                                          
                                           Additional Banquet:   $ _________
                                          
                                           Sunday Theatre Trip:  $ _________       
                                              
                                           Total:                $ _________
                                              
                                              
                                              
      
Make checks or money orders payable to "SBF 266430".


Mail payment and registration form to:

   Joan Napolitano, NNN99 Workshop Secretary
   High Energy Physics Group
   Dept. of Physics and Astronomy
   State University of New York at Stony Brook
   Stony Brook, NY, 11794-3800
   U.S.A.