Mathematical
Association of
America

Mathematical Study Tour of The Ancient Mayan

December 26, 2006 to January 2, 2007

TO REGISTER:
MAIL: Send completed form with $500 per person deposit to the following address:

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

FAX: Fax completed form to us at:(202) 293-3412
ELIGIBILITY: Participation is a benefit of membership. Only one membership per household is required.
Last NameFirst NameDr/Mr/Mrs
Street
CityStateZip
(Area Code) Day Phone(Area Code) Evening Phone
Email Address
Name for Badge
 
Last NameFirst NameDr/Mr/Mrs
Street
CityStateZip
(Area Code) Day Phone(Area Code) Evening Phone
Email Address
Name for Badge
PAYMENT INFORMATION
 I am enclosing my check payable to: The Mathematical Association of America
 I authorize The Mathematical Association of America to charge my payment to:
Visa Mastercard
$
Amount
Name   (as it appears on card)
Card Number
Expiration Date
Signature
ACCOMMODATIONS
Check One:
 I desire to share a room with __________________________ (roommate's name)
 I am travelling alone & wish to share a room
 Non-smoking  Smoking
If a roommate cannot be found by the time of final invoicing, the single supplement will be charged.
 I prefer a single room, where available, at the supplemental price
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