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BioForum Registration

Please print this page, fill out the form below, and send the completed registration form, with check payable to "CAS BioForum" for $15.00 per BioForum ($45 for all three) to: BioForum, Education Department, California Academy of Sciences, Golden Gate Park, San Francisco, CA 94118.

Note: No district invoices will be accepted.
__ Microbes 10/24/98
__ Conservation Biology 2/6/99
__ Modern Systematics 4/17/99
__ All 3 in BioForum Series($45)

(Please print.)

Last, First Name
 
E-mail Address
Home Address
 
School Name
City, State, Zip
 
School Address
County School City, State, Zip
 
Home Phone School Phone


Student Teachers:

University or College ____________________________________

Name and Title of Supervising Professional _____________________________

Registration Deadlines
   * October 16, 1998 for Microbes
   * January 29, 1999 for Conservations Biology
   * April 9, 1999 for Modern Systematics

For Office Use Only:
 
Check#
 

Confirmed w/receipt
 

Entered CAS DB
 



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