Excellence in Teaching Undergraduate Science and Mathematics: National and Chicago Perspectives January 28, 2000—DePaul University Loop Campus March 24, 2000—The Adler Planetarium May 5, 2000—Peggy Notebaert Nature Museum, Lincoln Park Registration Form Participant’s Information (please print): Name ____________________________________________________________________________ Position _________________________________________________________________________ Address __________________________________________________________________________ City _________________________________________ State ______________ Zip ____________ E-mail address ____________________________________________________________________ Telephone _________________________________ Fax __________________________________ Badge Information (please print): Name & Department _______________________________________________________________ Institution/Affiliation ______________________________________________________________ Symposium Selection: Registration for the full series or for individual symposia. Full three-symposium series ($75) __________ January 28 symposium—DePaul University Loop Campus Regular ($30) __________, Student ($15) __________ March 24 symposium—The Adler Planetarium Regular ($30) __________, Student ($15) __________ May 5 symposium—Peggy Notebaert Nature Museum, Lincoln Park Regular ($30) __________, Student ($15) __________ Dinner: Dinner is included as part of the symposium. __________ I would like a vegetarian dinner. Payment: A check for $__________ (made out to University of Illinois at Chicago) is enclosed. Please mail to: Attn: Symposia Registration Institute for Mathematics and Science Education, University of Illinois at Chicago (M/C 250), 950 S. Halsted, Room 2075 SEL, Chicago, IL 60607-7019 Please use a separate form for each participant. Duplicate as necessary.