29th LUNAR AND PLANETARY
SCIENCE CONFERENCE

March 16-20, 1998
Houston, Texas

PREREGISTRATION FORM

You MUST return this form to LPI no later than February 23, 1998, to avoid the $20.00 late fee.

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 6.

____ × $50Professional Registration through 2/23/98$_________
____ × $70Professional Registration starting 2/24/98$_________
____ × $30Student Registration through 2/23/98$_________
____ × $50Student Registration starting 2/24/98$_________
____ × $0Working Press (ID required)$_________
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 23, 1998, TO 29th 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:  tanner@lpi.usra.edu).



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