TAS 2010 ANNUAL MEETING REGISTRATION FORM

 Each person MUST register individually. When registering each person must open a new browser window and not reuse the same cleared form. Please write a separate check for each registrant.

Register early because payment must be mailed and received by 
February 15 for pre-registration.

 

Please complete the registration form below. You must be a member to register. If you need to pay your membership dues then select the appropriate membership classification.   Please click the Submit button at the bottom of the page to calculate your total and review your order.

Print two copies of the notification email.  Keep one as your receipt and mail the other with your check (print the registrant's name on the comment line) payable to Texas Academy of Science to Fred Stevens, Schreiner University, CMB 6252, Kerrville, TX 78028.

*First Name:
*Last:
*Name Tag:
*Address Line 1:
Address Line 2:
*City:
*State:
*Zip:
Country:
*University/Business:
Department:
*Phone:
*Email:
Late Registration and Refund Information Late registration begins February 15, 2010.  Late registration fees are in parentheses.  Late registration does not guarantee a banquet meal for the  registrant. Registration refunds minus a $10 handling fee will be available until February 23, 2010 if requested by mail.  Requests for refunds must be postmarked before midnight, February 22.  Send the refund request to Fred Stevens, Schreiner University, CMB 6252, Kerrville, TX 78028.
*Registration Category (late fee in parentheses):	$45 - Student (Graduate or Undergraduate) ($60) $140 - Professional (Non-Student) ($165)
Purchase a Printed Program:	$5 - Yes
Number of Guests - $50 per guest ($75 after 2/15 late registration):
Guest Name Tags:
*What is your first area of interest?:	- Select One - Anthropology Biomedical Botany Cell and Molecular Biology Chemistry and Biochemistry Computer Science Conservation Ecology Environmental Science Freshwater Science Geosciences Marine Science Mathematics Physics Science Education Systematics and Evolutionary Biology Terrestrial Ecology and Management
Second Area of Interest:	- Select One - Anthropology Biomedical Botany Cell and Molecular Biology Chemistry and Biochemistry Computer Science Conservation Ecology Environmental Science Freshwater Science Geosciences Marine Science Mathematics Physics Science Education Systematics and Evolutionary Biology Terrestrial Ecology and Management
Third Area of Interest:	- Select One - Anthropology Biomedical Botany Cell and Molecular Biology Chemistry and Biochemistry Computer Science Conservation Ecology Environmental Science Freshwater Science Geosciences Marine Science Mathematics Physics Science Education Systematic and Evolutionary Biology Terrestrial Ecology and Management
If you need to pay membership dues, please select a membership category:	$15 - Student Membership or Invited Speaker $30 - Senior Academy Regular Membership $60 - Supporting Member (Regular plus donation) $100 - Sustaining Member (Regular plus donation) $150 - Patron (Regular plus donation) $150 - Corporate Member $35 - Joint Member (Two members receive 1 journal) $10 - Emeritus Member (Retired member)
T-Shirt Order - T-shirts are $15 each. Please enter the number of T-Shirts you want in each size.
Small:
Medium:
Large:
XL:
XXL:
Head Count for Meals Please indicate the number attending for each event.
*Thursday Night Reception:
*Friday Lunch:
*Social hour before Friday Banquet:
*Friday Evening Banquet - Required to receive Student Awards:
Note:  Late registration does not guarantee a banquet meal for the registrant. Please register before Feb. 15.
Do you require vegetarian meals?:	Yes
Field Trip Opportunities Please enter the number of people participating in the field trip.
Field Trip - Erath and Palo Pinto counties - discover Pennsylvanian deltaic deposits and collect fossils plus a stop in Thurber to consider Industrial History and Coal mining in Texas. :
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Total Fee:	0.00
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Print two copies of the notification email.  Keep one as your receipt and mail the other with your check for the total fee listed above.  Please print the registrant's name on the comment line of the check.  Make it payable to Texas Academy of Science and mail to Fred Stevens, Schreiner University, CMB 6252, Kerrville, TX 78028.