Fee Form: NWMI Summer Program 2010

First, fill out the ONLINE REGISTRATION FORM. Then print out this form, fill in all items, and send it with your payment to the address below.

Name _________________________________________
Home Address _________________________________
______________________________________________

Home phone(____) ______________ Email (including summer) ________________________________________

Signature ____________________________________

PLEASE CIRCLE THE ITEM IN THE TABLE that you are registering for.

Please include a check or PO payable to Department of Math, University of Washington.

Five-Day Program (Summer Geometry Institute or Rich Math Tasks) Postmarked June 15 or before Late (after June 15)
Teach in Washington State
$50
$75
Out-of-State (with 5 nights lodging)
$650
$675
Out-of-State (no lodging)
$300
$325
Three-Day Program (Rich Math Tasks Algebra or Experiencing Research) Postmarked June 15 or before Late (after June 15)
Teach in Washington State
$30
$55
Out-of-State (with 3 nights lodging)
$390
$415
Out-of-State (no lodging)
$180
$205
Two-Day Program (Rich Math Tasks Geometry or Numerical Delights) Postmarked June 15 or before Late (after June 15)
Teach in Washington State
$30
$55
Out-of-State (with 2 nights lodging)
$260
$285
Out-of-State (no lodging)
$120
$145
Mail to: NWMI
University of Washington
Department of Math, Box 354350
Seattle, WA 98195-4350
Phone: (206) 543-1150
Fax: (206) 543-0397
Email: nwmi@math.washington.edu
Web page: http://www.math.washington.edu/~nwmi