APPLICATION: NWMI Summer Geometry Institute, July 30-August 4, 2006
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) Check One!
Yes _______ No ________
School _____________________________________________
School Address _____________________________________
___________________________________________________
Phones:
Home (____) ______________ Work (____) ________________ Fax (____) _______________
Email ________________________________________
Signature ____________________________________
Please include a check or PO payable to Dept.of Math, University of Washington.
| |
Postmarked June 15 or before |
Late (after June 15) |
| Teach in Washington State |
$75 |
$100 |
| Out-of-State (with 5 nights lodging) |
$550 |
$575 |
| Out-of-State (no lodging) |
$300 |
$325 |
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