Mathematical
Association of
America

MAA Study Tour to China

June 6 - June 21, 2006

TO REGISTER:
MAIL: Send completed form with a $1000 deposit per person to:

Lisa Kolbe, Development Manager
Mathematical Association of America
1529 18th St.,NW
Washington, DC 20036

FAX: Fax completed form to (202) 293-3412
Attention: Lisa Kolbe
ELIGIBILITY: Participation is a benefit of membership in the MAA. Only one membership per household is required. Participants must be 18 years or older.
Last NameFirst NameDr/Mr/Ms/Mrs
Street
CityStateZip
Home PhoneWork Phone
Email Address
Name for Badge
 
Last NameFirst NameDr/Mr/Ms/Mrs
Street
CityStateZip
Home PhoneWork Phone
Email Address
Name for Badge
PAYMENT INFORMATION
 Enclosed is my check payable to The MAA.
 I authorize The MAA to charge my payment to:
Visa Mastercard
$
Amount
Name   (as it appears on card)
Card Number
Expiration Date
Signature
ACCOMMODATIONS
Check One:
 I will be sharing a room with __________________________
 I am traveling alone.
 Non-smoking  Smoking
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