NWMI Summer Geometry Institute Application

APPLICATION: NWMI Summer Geometry Institute, August 11-16, 2002

Print out this application, fill in all items, and send it with your payment to the address below.

Name _________________________________________

Home Address _________________________________

______________________________________________

Housing on campus? (Sunday night through Thursday night for no additional charge.)

Check One! Yes _______ No ________ .

School _____________________________________________

School Address _____________________________________

___________________________________________________

Phones

Home () Work () Fax () ______

Email ________________________________________

Signature ____________________________________

Please include a check or PO for $150 payable to Dept. of Math, University of Washington.

Mail to:

NWMI
University of Washington
Department of Math, Box 354350
Seattle, WA 98195-4350

Phone: (206) 543-1915 or 543-1150 Fax: (206) 543-0397
Email: nwmi@math.washington.edu
Web page: http://www.math.washington.edu/~nwmi