DUG 2011 Registration

DUG 2011 Registration - General Details

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Annual Meeting Registration and DUG Membership Form

The DUG2011 Annual Meeting will take place at Stardome Observatory in Auckland New Zealand from 2-4 November 2011 with pre DUG training from October 31 2011.
For more details, including accommodation options, please refer to the meeting site at http://DUG2011.wordpress.com
Please complete one form per delegate, and submit the completed form before October 1st 2011 to avoid the $40.00 late fee. Refunds will be given up to October 14th. If registering after October 17th do not mail a cheque but bring it with you to the meeting, or arrange for a bank transfer.
Please note all information collected in this form will be kept confidential and not communicated to other parties without your consent.

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1. Name

Name

2. Work Phone

Work Phone

3. Title

Title

4. Home Phone

Home Phone

5. fax Number

fax Number

*
6. First DUG Meeting

First DUG Meeting Yes

7. Email Address

Email Address

*
8. Institution

Institution

*
9. Street Address

Street Address

*
10. City

City

11. State/Province

State/Province

12. Postcode

Postcode

*
13. Country

Country

14. Special Meal Requirements

Special Meal Requirements

15. Other Needs

Other Needs

DUG 2011 Registration