Registration Form Name___________________________________________________________________________ Affiliation____________________________________________________________________ Phone _____________________________E-Mail _____________________________________ MEAL RESERVATIONS MUST BE RECEIVED BY: April 22, 2005 Friday Luncheon ($7.00) Number __________ Cost __________ (Vegetarian entree ____) Friday Banquet ($14.00) Grilled Salmon Number __________ Cost __________ Highland Stuffed Chicken Number __________ Cost __________ Vegetarian entree Number __________ Cost __________ Saturday Breakfast ($6.00) Number __________ Cost __________ Saturday Luncheon ($9.00) Number __________ Cost __________ (Vegetarian entree ____) Name(s) of Guest(s) ___________________________________________________________ Section Dues/Registration Fee ($15.00) Cost __________ Participants who have already paid their 2004-2005 annual Section dues do not need to pay any additional registration fees. No dues or fees are charged for student participants or for family members who do not attend sessions. Total Enclosed __________ Please check the category that best describes your situation: Undergraduate student _____ Graduate Student _____ Educator: K-12 ____2-year College ____4-year College ____University ___ Business/Industry_____ Government_____ Retired_____ Other (please specify) ______________________________ Make your check for registration and meals payable to Michigan Section-MAA and mail it with this form (or a copy of this form) to: Debbie Smith Department of Mathematics & Computer Science Alma College 614 W. Superior St. Alma, MI 48801
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