Registration Form
Finite Simple Groups, Geometries, Buildings, and
Related Topics
Conference in Honor of Ernest Shult
March 22-24, 2001
Kansas State University, Manhattan, Kansas
Last Name: ____________________________________________First
Name: ___________________________________
Affiliation: ___________________________________________________________Titlle/Grad.
St___________________
Mailing Address: ____________________________________________________________________________________
City/State//Zip Code_______________________________________________Country___________________________
E-mail Address: _________________________________________________________________________
Telephone: ______________________________________
Fax: _______________________________
___ $60 Registration
Fee (including conference banquet cost) or
___ $20 Banquet only (not registering for conference)
___ $2
On-campus Parking Permit for Thursday and Friday (if not staying at Ramada
Inn and needing to park car on campus)
$_________
Amount Enclosed
| Method of Payment:
|
_____ Check (in
US dallar and payable to Kansas State University, FEIN #48-0771751)
_____ Invoice
my
organization P.O. #________________________
_____ Charge Card:
____Mastercard, ____Visa |
| Charge card number
_________________________________
Print cardholder name
_________________________________ |
Expiration Date(mm/yy)___________________
Signature
___________________________________ |
Disinner Selection
for Conference Banquet (on Friday, March 23, in Ramada Inn Plaza Hotel.)
(
) Roast Beef Burgundy
( ) Chicken Kiev,
( ) Salmon Filet
Please return this
form to
by March 1, 2001.
|
Math Conference Registration
Division of Continuing
Education
Kansas State University
141 College Court
Building
Manhattan, KS 66506-6015
Tel.: 1-785-532-5569,
Fax: 1-785-532-2422 |
Hotel Information:
Participants are responsible to make hotel reservations
directly with the hotels. However if you are abroad and can not make a
reservation yourself. Please sned email to zlin@math.ksu.edu or
chermak@math.ksu.edu
and we will help. Plesae visit theconference web
page at http://www.math.ksu.edu/conf2001 for more details on local information.
Special Assistance
Kansas State University is
committed to making program activities accessible to all participants.
If you have special requirements due to disabilities or dietary restrictions,
indicate your needs on the registration form or contact the Division of
Continuing Education Registrar at (785) 532-5566 at least three weeks before
the start of the program. After this date, we will make every effort to
provide assistance, but cannot guarantee that requested services will be
available.
Notice of Nondiscrimination
Kansas State University is
committed to a policy of non discrimination on the basis of race, sex,
national origin, disability, religion, age, sexual orientation, or other
nonmerit reasons, in admissions, educational programs or activities, and
employment (including employment of disabled veterans and veterans of the
Vietnam Era), all as required by applicable laws and regulations. Responsibility
for coordination of compliance efforts and receipt of inquiries, including
those concerning Title IX of the Education Amendments of 1972 and Section
504 of the Rehabilitation Act of 1973, and the Americans with Disabilities
Act, has been delegated to Jane D. Rowlett, Ph.D., Director, Unclassified
Affairs and University Compliance, 225 Anderson Hall, Kansas State University,
Manhattan, KS 66506 0124 (913/532 4392).