Pre-Registration

5^th Annual Spring Meeting of the NCS-AAPT
Davidson College
Davidson NC 28036
March 17-18, 2000

Name (Please print clearly)       ___________________________________________

Preferred Name for name tag    ___________________________________________

Preferred Mailing Address        ___________________________________________

                                                ___________________________________________

                                                ___________________________________________

                                                ___________________________________________

Institution                                  ___________________________________________

Work Phone                             (      )_____________________

FAX                                        (      )_____________________

Home Phone                            (      )_____________________

E-mail                                      _________________________

Registration:                  Member (includes lunch)                       $16.00             ________

Non-Member (includes lunch)               $23.00             ________

High School teacher (includes lunch

 and make and take session)     $10.00             ________

Workshop:

            Friday: PTRA make and take    (included)         ________

            Saturday:

Physlets                        $  5.00             ________

            Nuclear Science           $  2.00             ________

             Physics in Music           $  3.00             ________

Dues ($5.00 per year)                                                  ________

Total                                                                            ________