Chapman Conference on Magnetic Helicity in Space and Laboratory Plasma

July 28-31, 1998
Boulder, Colorado

REGISTRATION FORM
DEADLINE: JUNE 26, 1998

Name:_______________________________________________________

Badge
Name:_________________________________________________

Address:____________________________________________________

City:_______________________________________________________

State/Province:_____________________________________________ 

Zip/Postal
Code:____________________________________________

Country:____________________________________________________  

Phone:______________________________________________________    

Fax:________________________________________________________

E-mail:_____________________________________________________

REGISTRATION FEES:  There are no one-day pro-rated
registration fees. Participant registration fees cover
admission to all scientific sessions,  shuttle service to/from 
meeting site, refreshment breaks, reception, and conference 
dinner. Please check off the appropriate registration box:

[  ]  Scientists $230
[  ]  Students   $115

EXTRA TICKETS:  Registrants may purchase extra reception and
conference banquet tickets for accompanying persons:

[  ] Reception $20.00 each x ____ tickets = ____
[  ] Banquet   $30.00 each x ____ tickets = ____

TOTAL AMOUNT ENCLOSED  (Registration and Extra Tickets): 
           $________

PAYMENT INFORMATION: Payment in U.S. dollars must
accompany this form.

[  ] Check (payable to AGU)

or

Credit Card:

[  ] AMEX     [  ] VISA      [  ] Mastercard    

Cardholder's Name:____________________________________

Card No.: ________________

Exp. Date:________________

Zipcode of Billing Address:________________

Please indicate any special requests, needs or restrictions,
such as disabilities, or dietary restrictions:

COMPLETE THIS FORM AND RETURN BY JUNE 26 TO:

Return to Chapman Conferences
Return to Meetings