DOWNLOADABLE PREREGISTRATION FORM

You MUST return this form to LPI no later than August 21, 1998, to avoid the $20.00 late fee.
Please submit a separate preregistration form for each individual who wishes to attend.

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 September 11, 1998.

____ × $50Professional Registration through 8/21/98$_________
____ × $70Professional Registration starting 8/22/98$_________
____ × $30Student Registration through 8/21/98$_________
____ × $50Student Registration starting 8/22/98$_________
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 August 21, 1998, TO Moon98 Workshop 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:   tanner@lpi.usra.edu).


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