ArtSci2002 REGISTRATION FORM   Pre-Registration Ends November 30 , 2002 [November 1st deadline for group rate on EINSTEIN exhibition.]   Please copy, fill-out and print this form & mail with your check [or email to: office@asci.org if paying via Paypal.com]. FIRST NAME: _________________________________     LAST NAME: _________________________________ ADDRESS: _________________________________ INSTITUTIONAL AFFILIATION: ___________________________ SPECIFIC PROFESSION  ____________________________________ [ie. marine biologist; multimedia artist]: IS YOUR WORK COLLABORATIVE:  __YES     __NO  __SOMETIMES EMAIL: _________________________________ PHONE: _________________________________ URL: [you & your work] _________________________________ Can we post your information above in our "Attendees Listing"?  YES / NO This is a great way to meet people in advance of the event and a resource to the public on your work via your URL. You may elect not to have your phone# printed, and/or create a new email address for such public purposes. EVENT FEES: Circle the amounts you are paying for:   Pre-Registration (non-ASCI member) Sat./Sun. Symposium only   $75/day or $120/2-days Pre-Registration Price ASCI Member Sat./Sun. Symposium only $50/day or $80/2-days Pre-Registration Price Students/ Seniors Sat./Sun. Symposium only. $30/day or $45/2-days On-Site Registration (cash only!) $100/day or $150/2-days (students/seniors: $50/day or $80/2-days) ART-SCI Social Mixer FREE with symposium badge [you must register for at least one symposium day] Friday evening Keynote                 SOLD OUT !   Number of persons attending: ____ Are you a current ASCI member: ___YES ___NO ASCI Membership (new & renewal) www.asci.org/about/form.html There are several different ASCI Membership categories, so you must print-out the Membership Form separately and include with your Registration to receive ASCI Membership discount. [AND as a member, you receive ASCI's monthly ebulletin.] * EINSTEIN exhibition: pay ASCI by Nov. 22, 2002 to receive the group rate! ** reduced rates for students, seniors, and AMNH members *** Students must photocopy their Student ID and mail with their Registration. CIRCLE day(s) you will attend:   FRIDAY   SATURDAY   SUNDAY   ALL TOTAL AMOUNT ENCLOSED: $_______  [checks on US-dollars accounts ONLY] Printed Registration form must be mailed with your check to:  "ASCI" [You may also send a "Postal Money Order" with Registration Form.] MAIL TO: ArtSci2002 ASCI P.O. Box 358 Staten Island, NY 10301 USA NO TICKETS .... after receiving your payment, ASCI will E-MAIL CONFIRMATIONS. Print-out + bring email as your event ticket!     How did you learn about this Symposium? _________________________________________________________