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PREP 2002 WORKSHOPS CONTACT INFORMATION (Please type or print): First Name ____________________________ M. I. ____ Last Name _______________________________________________________ Institution: ________________________________________________________ Address: ______________________________________________________________ ______________________________________________________________________ City: _________________________________ State/Province: _______ ZIP: ________________ Country: ____________ Phone (w/Area Code): ____________________ FAX:____________________ Email: __________________________ PROFESSION: [ ] Faculty at Two-Year College [ ] Faculty at Four-Year College/University [ ] High School faculty [ ] Graduate Student [ ] Other: ___________________________ 2002 WORKSHOP CHOICE : Please indicate your first (1), second (2) and third (3) choices, as enrollment is limited. [ ] Presenting Math Masterpieces, Burger & Starbird; [ ] Regression Analysis, Scheaffer; [ ] Authoring Online Materials, Moore; [ ] PMET, Dubinsky; [ ] Explorations in Finite Mathematics, Shahin; [ ] Mathematical Modeling, Dossey/Giordano[ ] Dept. Chairs, Straley/Scott [ ] Knot Theory, Adams REASONS FOR APPLYING: Please attach a separate page which briefly explains the reason(s) you wish to attend the indicated workshop, and how you plan to use what you learn. HOW TO SUBMIT YOUR REGISTRATION: Mail this registration form and attached written statement to:
HOW TO FAX OR E-MAIL YOUR REGISTRATION: This application may be downloaded and either faxed or e-mailed to the MAA. The fax number is 202-483-5450, e-mail for Gretchen Brown is gbrown@maa.org |