*** 2006 Fall Meeting News Media Registration Form ***



Name (to be printed on badge):      
Media or organizational affiliation:      
Title:      
Mailing Address:      
 

Telephone:          Fax:  
 
Email Address:      
 
Freelancers Only: Describe your eligibility (check one only) and bring relevant proof to the meeting.
(Select one)

      _____ Member of NASW
      _____ Regional affiliate of NASW
      _____ CSWA
      _____ ISWA
      _____ SEJ
      _____ Letter from recognized publication assigning you to cover this meeting
      _____ Evidence of bylined science story published in 2005 or 2006

Field Trip Registration:
checkbox I would like to participate in the field trip to MBARI on Sunday, 10 December.

 
Press pre-registration deadline is Friday, 1 December 2006. Form must be received at AGU by that date for your badge to be available upon arrival, avoiding delay. You may also register on site. 


Mail to:
Harvey Leifert
AGU
2000 Florida Avenue, N.W.
Washington, DC 20009
USA
  Fax to:
Harvey Leifert
AGU
+1 202-328-0566