Harry Petschek Symposium on Magnetic Reconnection

March 21-23, 2006

Registration and Payment Form

Full Name (First/Family) :

Mailing Address :

Email : Tel : Fax :

Name Preferred for the Name Tag :

Title of Poster Presentation (optional):

Please pay the registration fee by a certified or personal check. Make the check payable to the Harry Petschek Symposium. Mail this registration form and payment to the Harry Petschek Symposium, IREAP, Bldg. #223, University of Maryland, College Park, MD 20742, USA.

Registration fee: Before February 3, 2006: USD $300, after that date: USD $350.

Registration fee includes coffee breaks, the Wednesday conference dinner, breakfast and lunch for three days and parking.