Registration Form

Please complete this form to register for the 2009 February Fourier Talks at the Norbert Wiener Center in the Department of Mathematics at the University of Maryland, College Park. Make sure to complete the required fields marked with a “*”.

Registration fee schedule:

		On or before January 8		After January 8
Students and government employees		Free		Free
All other non-students		$45		$60

First name:*
Last name:*
Email address:*
Affiliation (Company or Institution):*
Registration Status:* Student (free) Government Employee (free) Other non-student ($60 fee)
Attending: Thursday talks Thursday dinner Friday talks
Address:

Phone:

* = Required field!