Registration Page
Name:__________________________________________________________
Position or Title:__________________________________________________
Institution:______________________________________________________
Address:________________________________________________________
Phone:________________________________e-mail: ____________________________
Workshop Registration:
Modeling ($5) ______
Dark Matter ($15) ______
Cool Astronomy ($5) ______
Conference Registration: $40 ______
Friday Night Banquet: $40 ______
Total ______
Subtract $10 if you are a lifetime member of NES-AAPT Checks should be made out to Thayer Academy
Alternatively, you may call in your credit card number to Thayer Academy.
Call Don Donovan at 781-664-2216 Please mail registration form and checks should be mailed to:
Don Donovan
Head, Science Department
Thayer Academy
745 Washington St.
Braintree, MA 02184
Forms must be received by April 20th
To pay by Credit Card:
Type of Card:_________________________________
Account #____________________________________
Name on Card_______________________________
Exp Date_____________________________________
Security Code_________________________________