Registration form for the 25th Annual Anja S. Greer Conference on Secondary School Mathematics, Science and Technology

June 21 - 26, 2009

   Registration process: (You must complete all 4 steps to be registered)
      1 - COMPLETE all the required information on the form.
      2 - SUBMIT the form.
      3 - PRINT the receipt.
      4 - MAIL a copy of the receipt with your check for $900 to the address at the bottom of the receipt page.

Attendee

First Name *
Last Name *
Address Line 1 *
Address Line 2
City *
State *
Zip *
Country *
Phone *
Fax
Email *
Re-Type Email*
(MST Conference correspondence will be sent via email, unless otherwise requested.)

School

School Name *
Address Line 1 *
Address Line 2
City *
State *
Zip *
Country *
Phone
Fax

Course Selection

Please select courses from the drop down list (courses are listed numerically) in order starting with Course I and three backup courses, followed by your selections for Course II. For course descriptions click here.

	Preferred	2nd Choice	3rd Choice	4th Choice
Course I
Course II

I am interested in earning graduate credit for my participation in the conference. For information click here.

Housing Request

I would like to request dormitory housing Gender: MaleFemale

All accommodations are single room unless otherwise indicated by both participants writing in the name of their desired roommate. Roommates must be of the same gender.

Roommate's name (if applicable)

Optional Off-Campus Trip - Tuesday Click here for trip descriptions.

Select a preference for an off campus venue:BostonSeacoast Tour

The conference will have T-shirts available for purchase, please indicate your preferred size.
Shirt Size
SMLXLXXL

Payment Information
Funded by Stranahan Foundation

Contact Information: Conference Director: Tom Seidenberg | Telephone: (603) 777-4471