IACT - Registration



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I.A.C.T. Registration Form
(Fall Meeting at Illinois Central College in East Peoria on October 16-17, 2009)

Click Here to Register

In 2009, we will be holding a two-day meeting in conjunction with the

Illinois Section of the American Association of Physics Teachers

Click here for more information

Please fill out the application form and press submit. You will then be presented with payment options.

If you are taking advantage of our special "Register two members together to receive one lunch for free", please fill in the column on the right as well. Note that mandatory fields are denoted with an asterisk.

Registrant #1

Registrant #2

* Name:

Title:

Organization:

* Street Address:

Address (cont.):

* City:

* State:

* Zip Code:

* Country:

Work Phone:

FAX:

e-mail address:

URL:

Registration Options:

I Would Like To (choose one):

	Pay my conference registration for $45.00
	Pay 2 conference registrations for $80.00
	Pre-service science teacher registration free

A limited number of vegetarian meals will be available on site. Please contact wjhunte@ilstu.edu if you wish to make a vegetarian meal request.