Return this form to LPI no later than February 18, 2000.
Each registrant must submit a separate form (feel free to make as many copies of this form as needed).

Please abbreviate long names and affiliations the way you would prefer to see them on your badge.

NAME:  _________________________________________________________________

AFFILIATION:  __________________________________________________________

ADDRESS: ______________________________________________________________


PHONE:  __________________________ FAX: _________________________________

E-MAIL:  ________________________________________________________________

Payment must accompany form. Foreign participants may return this form and pay in cash at the meeting. Cancellations with requests for refunds will not be accepted after March 3, 2000.

____ @ $50.00Professional Registration through February 18 $_________
____ @ $70.00Professional Registration starting February 19 $_________
____ @ $30.00Student Registration through February 18 $_________
____ @ $50.00Student Registration starting Febraury 19 $_________
____ @ $00.00Working Press $_________
Total Enclosed$_________

Please Indicate Method of Payment

OCheck or money order payable to the Lunar and Planetary Institute
(checks must be in U.S. dollars drawn on a U.S. bank).
OAmExO VISA O MasterCard

Card Number  _______________________________________  Expiration Date  ____________________

Name as It Appears on Card (PLEASE PRINT)  ______________________________________________

Signature  ____________________________  Authorization Code (LPI USE ONLY)  ________________

RETURN THIS FORM BY FEBRUARY 18, 2000, to 31st LPSC Registration, Lunar and Planetary Institute, Publications and Program Services Department, 3600 Bay Area Boulevard, Houston TX 77058-1113. For registration information contact the LPI Publications and Program Services Department (phone:  281-486-2142; fax:  281-486-2125; e-mail:

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