Registration for Zone X Conference 2012

Registration for Society of Physics Zone X Conference 2012 at Henderson State University 

 

First and Last Name:

  

Classification:

            

Chapter (University):  

 

Registrant Information:

Street Address:  

City:  

State:  

Zip Code: 

 

E-mail:

Phone Number: 

 

Research Presentation Information:

We invite anyone who is interested to give either a 10-15 minute presentation of their research and/or to present a poster.  You may select either or both options.  If you are interested in presenting your research, please complete the information in this section.

         

Title of talk and/or poster presentation:

 

Please list any special dietary concerns below (vegetarian, vegan, lactose intolerant, etc)

 

 

Shirt Order Information:

If you would like to preorder shirts for the conference, please note the number of each size you would like here.  Send a check for $10 per shirt made out to HSU Society of Physics Students to:

Dr. Shannon Clardy

Henderson State University

1100 Henderson Street

Box 7743

Arkadelaphia, AR 72019

Small:

Medium:

Large:

XLarge:

XXlarge:  

We will also have shirts available for sale at the conference, however, we cannot guarantee that your size will be available unless you preorder your shirt before February 27th.

 

When you successfully submit your registration form, you will be returned to the Zone X conference information page.  We are looking forward to seeing you in March!

 

 

 
 
 
 
Weather Icon
Javascript must be enabled to view the current weather conditions