REGISTRATION FORM


I would like to particpate in the AGS-2000 Workshop at BNL on May 12-17, 1996.


Name:___________________________________________________

Affiliation:____________________________________________

Mailing Address:________________________________________

                ________________________________________

                ________________________________________

Telephone:______________________________________________

Fax:____________________________________________________

E-Mail:_________________________________________________


I am interested in the topic:________________________________________________

I would like to propose the new topic:_______________________________________


Dormitory reservations                  Gender:   M __    F__

Check in date __________________   Check out date _________________

Residence dormitory ($14.50/night)
(private room with shared bath)

List of local hotels furnished on request


Registration fee of $100 is enclosed  ____ 

              will be paid on arrival ____

  Make checks payable to Associated Universities, Inc



Please reply by May 1 1996 to:

Elaine Zukowski
AGS-2000 Bldg 510F
Brookhaven National Laboratory
P.O. Box 5000
Upton, NY 11973-5000
Phone:  (516) 344-3866
Fax:    (516) 344-5820
E-Mail:  henp@bnl.gov

WWW: http://www.phy.bnl.gov/ags-2000/workshop.html