OUT-OF-STATE APPLICATION : NWMI MINICOURSES 2005
Print out this application, fill in ALL items, and send
with your payment to the address below.
Name ___________________________________________________________________
Home Address ____________________________________________________________
________________________________________________________________________
Check your choice of courses (max of ONE per session):
Session A. August 1 - 2
Fourth Dimension ______
Counting & Number Patterns _____
| Session B. August 3 - 4
Tessellations _______ |
Lodging: Yes __ No___ If yes, how many nights? ___
Check nights wanted: Su _____ M _____ Tu _____ W _____ Th _____
Your School _____________________________________________________________________
School Address __________________________________________________________________
_______________________________________________________________________________
Phones: Home (____) ____________ Work (____) ____________ Fax (____) ____________
Email ______________________________________________________
Signature __________________________________________________
Please include a check or PO payable to Dept.of Math, University of Washington.
(WA state teachers use WA form.
or Seattle Schools form.)
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ONE Course
|
TWO Courses
|
| |
(until 6/15) |
(after 6/15) |
(until 6/15) |
(after 6/15) |
| Registration |
$125 |
$150 |
$250 |
$300 |
|
Add Lodging = $50 * no. of nights
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| Write TOTAL |
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| Mail to: |
NWMI
University of Washington
Department of Math
Box 354350
Seattle, WA 98195-4350 |
Phone:
(206) 543-1915 |
Fax:
(206) 543-0397 |
Email: nwmi@math.washington.edu
Web page: http://www.math.washington.edu/~nwmi