SRC UM2004

Due October 1st, 2004

Contact Information

Name:
Organization:
Address:
City:
State/Province:
ZIP Code:
Country:
Phone:
FAX:
E-mail:

If you plan on presenting a poster:

How many? Format: Landscape Portrait

If you want the poster printed by SRC, please send to Chris Moore (cmoore@src.wisc.edu) by October 8th.

Registration Fee

Please check the sessions you will be attending. The registration fee includes breakfast, lunch, & breaks; the banquet is a separate fee. You are welcome to bring a guest to the banquet by indicating below.

Friday, October 15
Special Session ONLY (Inn on the Park, Madison)
Regular $30 Student $0

Friday & Saturday, October 15 & 16
BOTH Meeting Days (Inn on the Park and PSL, Stoughton)
Regular $55 Student $20

Friday Evening Banquet (Essen Haus, Madison)
Regular $20 Student $20 Guest $20

Parking is available at the Inn on the Park by indicating you are with the SRC Users' Group meeting. Please check here if you will need parking:

Yes No

I require vegetarian meals: Yes No

I have the following special needs:

You may pay on-site by cash or check only. Make checks payable to "University of Wisconsin-Madison". Credit cards can be processed prior to the meeting or on Saturday (will not be available at the Inn on the Park). To use a credit card, please fax or send in the paper version of the registration form.

Note: For UW employees, you may submit an internal requisition issued to the Synchrotron Radiation Center through your UW department, but it must state "confirming requisition" in the explanation and include the fund 128 A 34 9200 4 3350.