GeomFest 2006 / Department of Mathematics at the University of Pennsylvania


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REGISTRATION & BANQUET

First name
Family name
Email
Phone
University/Department
Mailing Address: (Number /Street)
(City)
(State/Province)
(ZIP)
(Country)
Arrival date:
Departure date:
Accomodations		Hotel where you will be staying (if you already know) during the Geometry Festival: Latham Club Quarters Sheraton Divine Tracy other
Financial Assistance:		Do you wish to apply for financial assistance: Yes No
Ph.D. Year student:		student 2002-2005 1999-2002 Before 1999

Banquet Information		On the evening of Saturday April 1, there will be a banquet. The cost will be $35. for faculty, $15 for students, and $35. for guests of either faculty or students. How many people in your party will attend the banquet on Saturday evening (include yourself, but do not include anyone else who is registering for the Geometry Festival on their own)? 1 2 3 or more Of these, how many are requesting vegetarian meals?
Registration Fee & Banquet Cost		There is a registration fee of $35 for faculty and $15 for students. In addition, if you are attending the banquet, there is a charge of $35 for faculty, $15 for students, and $35 for guests of either faculty or students. None of these fees apply to speakers and their guests. Please make out your check for the registration and banquet costs (if attending), to "The Trustees of the University of Pennsylvania ", and mail to Geometry Festival Department of Mathematics University of Pennsylvania Philadelphia , PA 19104-6395

Special needs, concerns or other comments:

Department of Mathematics
209 South 33rd Street
Philadelphia, PA 19104-6395
Email: dept@math.upenn.edu
Phone: (215) 898-8178 or -8627
Fax: (215) 573-4063