Return this form to LPI no later than February 22, 1999.

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

NAME:  ________________________________________________________________________

AFFILIATION:  _________________________________________________________________

ADDRESS: _____________________________________________________________________


PHONE:  _________________  FAX:  _________________  E-MAIL:  ______________________

If payment covers more than one person, please list their badging information.

Badge Name:  ________________________________ Affiliation:  _____________________________

Badge Name:  ________________________________ Affiliation:  _____________________________

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 5, 1999.

____ @ $50Professional Registration through February 22 $_________
____ @ $70Professional Registration starting February 23 $_________
____ @ $30Student Registration through February 22 $_________
____ @ $50Student Registration starting Febraury 23 $_________
____ @ $0Working 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 22, 1999, to 30th 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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