*** 2006 Joint Assembly News Media Registration Form ***

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

Telephone:          Fax:  
Email Address:      
If freelancer: Check one basis of your eligibility below and bring relevant proof to 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

Press pre-registration deadline is Monday, 15 May 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
2000 Florida Avenue, N.W.
Washington, DC 20009
  Fax to:
Harvey Leifert
+1 202-328-0566