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# Protostars and Planets V #### October 24-28, 2005 Hilton Waikoloa Waikoloa, Hawai'i, USA ## REGISTRATION FORM (ONE PARTICIPANT PER FORM) REGISTRATION FOR PROTOSTARS AND PLANETS V is CLOSED AS OF MIDNIGHT (HAST) OCTOBER 7th. Please forward any questions regarding registration to ppvreg@hawaii.edu Completed registration for the Protostars and Planets V consists of 1) completion and submission of your registration information on the form below and 2) receipt of faxed instructions for payment on the printed form provided. Your registration is not completed until we receive authorization for payment of your registration fee. ### Deadline for Early Registration is August 15, 2005 Required fields are marked with a red asterisk (*).
Section I: Personal Information
* Last Name : |
* First Name : |
Middle Initial : |
* Title : |
* Affiliation : |
* Phone : |
Fax : |
* Email Address: |
* Mailing Address : |
(line 2) : |
* City : |
* Province/State : |
* Postal code : |
* Country : |
* Name as you wish it to appear on badge: |
Do you require special accommodations during the conference? | If you require special accommodations, a representative from the Protostars and Planets V conference will be in contact with you.
Section II: Conference Registration Your conference registration includes, in addition to entrance to all sessions and programs/abstracts, an Opening Welcome Reception, Continental Breakfast and Lunch Monday through Friday, morning and afternoon Refreshment Breaks, and a Conference Dinner. Additional tickets for the Opening Reception and for the Conference Dinner are available for purchase on line.
* Registration Fee: Early registration deadline is August 15, 2005 |
Do you want to be notified by the Univ of Arizona Press when the Conference Proceedings become available for sale? |
Section III: Social Programs
Symposium Welcome Reception 6:00 pm, Sunday, October 23, 2005 Hilton Waikoloa The Symposium Welcome Reception IS INCLUDED in your registration fee. Guest reception tickets are available online for purchase. | Number of Guests: x $65.00/person
Conference Dinner 6:00 pm, Thursday, October 27, 2005 Hilton Waikoloa Cost of this event IS INCLUDED in your registration fee. Guest reception tickets are available for purchase. | Number of Guests: x $65.00/person
Section IV: Optional Post-Conference Tour of Mauna Kea The cost of the post-conference Tour of Mauna Kea is not included in the registration fee. Space is limited to 100 persons, and will be filled on a first come, first served basis. Additional persons will be accommodated on a space-available basis; please check with the conference registration desk at the beginning of the conference for wait-list and availability.
Post-Conference Tour of Mauna Kea Saturday, October 29, 2005 A Post-Conference field trip to tour the observatories on Mauna Kea has been planned. See fieldtrip descriptions in the accompanying descriptive material. Lunch is included. Enrollment limited to 100 participants. | x $175.00/person Attendee and Accompanying Adult (last, first): Person 1: Person 2: Person 3: Person 4:
Registration Closed

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