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REGISTRATION
FORM
Austen Riggs -
Adventures in Hemoglobin
Research
12-14
November, 2004
University
of
Texas
at Austin
| Complete this form and
return it no later than October 23,
2004.
DEADLINE
EXTENDED - Nov 1st
Click for a PDF copy of this form. |
Dr.
Thomas Baldwin, c/o Kim Bannister
Department
of Biochemistry
University
of
Arizona
Biological
Sciences West 362a
P.O.
Box 210088
Tucson
AZ
85721-008
FAX
(520) 626-9204
|
Registration
Information:
| First and Last Name (for badge) |
|
| Affiliation (for badge) |
|
| Mailing
Address: |
|
| Phone:
E-mail:
|
Fax:
|
|
Conference
Registration Fee: $40.00
(includes opening reception and refreshment breaks)
Note:
UT students and postdocs can attend the Saturday Conference
for no fee, but must register. |
Number Attending ______ |
| Banquet:
$50.00 |
Number Attending ______ |
PAYMENT:
Check or money order made payable to: University of Arizona - RiggsFest
Please
list any special needs:
Further
information on the program and local arrangements can be found on our
web site at:
http://www.cm.utexas.edu/riggsfest
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