DIMACS Workshop Registration Form

Meeting of the Mathematical Association of America - NJ Chapter

October 28, 2000

Please register by filling out the following blanks.

When finished and you have checked the correctness of information, press the "send" button at the bottom of the form.

Attendance is limited to available space; please register early.


  Dates you plan to Attend: 
Your First Name: Your Middle Name: Your last Name:
Your Position: (Please select best choice with button.)
Your Postal Address: (This information will be used for nametags & mailing lists) Name of organization: (University or Company Name)
Organization Type: (Please select best choice with button.) Department: Street Address: City, State, Zip Code: Country:
Phone: Fax: E-Mail: Web page URL:
Comments: (i.e. dietary restrictions)

Please indicate the following information in the comments section above:
- If you are an MAA Member
- If you will attend the luncheon
- If you would like to request seating at a luncheon discussion table (please indicate which discussion table).

Discussion Tables:
1. Directing Undergraduate Research
2. Creating Contacts with Industry to Help Students
3. Discussion for Department Chairs
4. Math Education for Elementary Teachers

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