24th Annual Midcontinent Paleobotanical Colloquium

Registration form
Due March 1, 2007

To register for the colloquium, you may pay by credit card using this secure online webpage, or you may print this form, complete it and send your check or money order in US dollars, made payable to SMU Midcontinent PC to:

Bonnie Jacobs
Department of Geological Sciences
P.O. Box 750395
Southern Methodist University
Dallas, TX 75275-0395

Name:

Preferred name for badge:

Institution:

Billing first name:*

Billing last name:*

Billing address:*

City:*

State:*

Zip code:*

Country:

Email:*

I plan to give a presentation at the 24th Midcontinent Paleobotanical Colloquium. The approximate title(s) of my presentation(s) will be:

(Abstract for MPC due on Feb. 15, 2007)

I prefer my presentation to be: (Please select appropriate choice)

oral

I do not plan to give a presentation.

Registration Fees

Please select the tickets you wish to order:

Midcontinent Paleobotanical Colloquium — March 16-17

	Professional ($65)
	Student ($35)

Field trip — March 18

Professional ($25)

Student ($15)

A box lunch will be provided.

Please enter any special dietary needs:

To continue your online registration and confirm your entries, click submit.