61st Annual Meteoritical Society
REGISTRATION FORM

 

Print out this form and return it to Ian Sanders, Metsoc98, Department of Geology, Trinity College, Dublin 2, Ireland (phone: +3531 608 1252, fax: +3531 671 1199, e-mail: isanders@tcd.ie, http://www.tcd.ie/Geology).

DO NOT SEND THIS FORM TO THE LPI!

Room descriptions, field trip outlines, and cancellation policies are all detailed in the second announcement.

Please write clearly:

Last Name (for badge): __________________________ First Name: __________________ M.I.: _____

Affiliation: __________________________________________________________________________

Address: ___________________________________________________________________________

__________________________________________________________________________________

Phone: _____________________________ Fax: ___________________ E-mail: __________________

I will be accompanied by ______ guest(s) and _______ child(ren).

Name(s): __________________________________________________________________________

__________________________________________________________________________________

Please check here [  ] if you require a vegetarian or special meal at the banquet.

(A) Registration Fees

Reduced fees apply until June 14, 1998

   No. of Persons    Before June 14  After June 14    Amount Enclosed
 Member __________
 @
 IR£145
 IR£170
  =   __________
 Nonmember __________
 @
 IR£185
 IR£210
  =   __________
 Student member __________
 @
 IR£80
 IR£100
  =   __________
 Student nonmember __________
 @
 IR£100
 IR£120
  =   __________
 Guest __________
 @
 IR£70
 IR£90
  =   __________
       TOTAL ENCLOSED
 = IR£
  __________

(B) University Accommodations (please book and pay by May 15, 1998)

I am making payment in full to reserve the following university room(s) for the person(s) named above.

Arrival day and date: _______________________ Departure day and date: ________________________

*If you want a standard single room, please circle gender:   Male / Female

** Standard double is a two-bedroom apartment. If you want a standard double room with rollaway beds for children under 14 (no charge), circle number of beds needed:   One / Two

Please state any special needs, e.g., a ground-floor room, early check-in after an overnight flight.

 Room type  No. of rooms  No. of nights  £ per night

 Amount
 *Standard Single  ______  ______  IR£30  ______
 **Standard double  ______  ______  IR£60  ______
 En suite single  ______  ______  IR£38  ______
 En suite twin  ______  ______  IR£66  ______
       TOTAL IR£  ______

(C) Postconference Field Trip (Please book and pay by March 30, 1998)

Please reserve _____________ places on a five-day field trip to western Ireland. I am paying in full, IR£240 per person. I require university accommodation on August 5 (circle Yes / No). If yes, I have added an extra night to (B) above.

 

 TOTAL

 IR£

  __________
 TOTAL for A + B + C

 IR£

  __________

You may copy this form if you do not wish to pay for items A, B, and C at one time.

Please Indicate Method of Payment:

Irish cheque [  ]    Eurocheque [  ]    Bank draft [  ]

Make payable in Irish pounds to 61st Meteoritical Society Meeting. Bank drafts must be drawn on an Irish bank.

Visa [  ]   Mastercard [  ]

Card Number: ____________________________________ Expiration date: ______________________

Printed Name as It Appears on Card: ___________________________ Signature: __________________