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Celebrating Science 2008 Registration Form

celebrating science 2008

NOTE: All required fields, denoted by a * must be filled out. If you receive an error, please refresh this page to receive a new image verification challenge.

First name: *    Middle Initial:
Last name: *
Email address: *
*
City: *
State/Region: * Postal code: *

phone:

Number of people attending*
  • people of age 16 and above.
  • kids of age 8 -15.
  • kids of age 1 - 7.

Enter each guest's name (for badging purposes).

                   first name        last name

attendee 1:

attendee 2:

attendee 3:

attendee 4:

Additional Information
TeamSETI member ?
Pre-sale T-shirts:
If you are interesting in purchasing T-shirt for this event, reserve yours here.
sizequantity
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M
L
XL
XXL
XXXL

To submit this form, please enter the characters you see in the image to the right:

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