Please fill the form out in its entirety
Registration Fee:$15
Name: 
Street Address: 
City and State Address:
Institution: 
Email: 
Phone: 

Check all that you would like to participate in or that do apply:
  Banquet on Saturday, February 4, 2006    ($15.00)
  Dorm:  One Night ($8.00) linens/towels not provided
  Dorm Two Nights ($15.00) linens/towels not provided
  Lunch ($5.00)
  Breakfast: do not check if you are staying in dorms ($5.00)
  I am a Vegetarian

(Please check all that apply) Staying in Dorms Feb 3     Feb 4 

Preferred room mate: 

  I will present a poster               
Title of poster: 

  I will present a presentation      
Title of presentation: 

T-Shirt Size:
Medium      Large      X-Large      XX-Large

Registration Payments are to be mailed to:
Marine Science Graduate Student Organization
Care of: Andy Canion
101 Bienville Blvd
Dauphin Island, AL. 36528
Make Checks Payable to Marine Science Graduate Student Organization

Late payments will be accepted during registration
(Friday, February 3,2006 7:00pm - 10:00pm)