2003 ANS Student Conference at Berkeley

Student Registration Form

Please fill out this form to register for the conference. Use the button marked "Submit Form" to email your information to the conference organizers. MAKE SURE YOU PRESS THIS BUTTON! If you need to make changes to any of your information later, you may return to this page and re-submit the form. If you are making changes, you only need to fill out your name, email address, and any information that has changed.

Some people have been having problems with the form submitting too early (such as if you accidentally hit Enter before you are ready to submit). This is okay - just close the confirmation window and finish filling out the form, then press the button when you're really done. We'll get two copies, but we don't mind.

We will send you an email within 5 business days confirming that we got your information.

SECTION 1: CONTACT INFORMATION

Is this a new registration or a change/addition to a previous registration?
New Change

Your Name (Prefix, First, Last):
Email Address:
University Affiliation:
Mailing Address Line 1:
Mailing Address Line 2:
City:
State or Province:
Postal Code:
Country:
Phone Number w/Area Code:

SECTION 2: LOGISTICS

If the answers to the questions in this section change, please take the time to come back to this page and let us know - it helps us schedule things.

Are you part of the AAA (Advanced Accelerator Applications) or ACFI (Advanced Fuel Cycle Initiative) program?
(If you don't know what this is, just put no.)
Yes
No

Are you expecting to submit an abstract for presentation?
Yes, I have already submitted one (or more)
Yes, but I haven't submitted yet
Maybe, maybe not - I don't know yet
No, probably not

What is your primary research interest?

What is your secondary research interest?

Are you a member of ANS National?
Yes, and my member number is
No

How are you paying for attending this conference?
(We are working on providing travel funding. We'll keep you posted on this one. Please note:
1) Travel funding will (in most cases) be proportional to distance traveled, and will almost certainly not exceed $300 / person.
2) ANS-Berkeley will give priority to people who don't have other funding (PLEASE be honest here!)
3) Only members of ANS National are eligible for travel funding (It costs $20 to join ANS-National. You do the math.))

My university or research program is paying for everything, but I'll take money if you give it to me
My university or research program is paying for part of the costs, but more is always nice
I am paying for everything, but I don't need travel assistance unless you have extra
I am paying for everything, and I could use some extra cash
I am paying for everything, and I absolutely won't be able to go without travel assistance

SECTION 3: WHAT DID WE FORGET?

Please enter any additional comments or instructions in the text box below:

SECTION 4: NOW YOU PAY US

So how much do you owe?

The cost for student registration is $25.
Additional tickets to the social event may be purchased for $10. Additional tickets to the Awards Banquet may be purchased for $15. (If you're bringing a friend to California with you and you'd like them to come to both the social event and the Awards Banquet, just have them register for the conference - that way they get access to breakfast, too!) If you would like to register now and purchase additional tickets later, no problem - simply return to this page to get the extra tickets.
Also, if you're feeling generous, why not donate some money to the conference? You get to be listed in the program. (We're required to tell you that the amount of your donation will have no impact on the amount of your travel assistance.)

Fill out the form below to add it all up.

Item	Amount
Registration Fee Number of Registrations: Enter 1 if you are registering for the first time. Enter 0 if you have already paid your registration fee and are here to buy tickets or donate money.	$
Extra Tickets Number of Extra Social Tickets: Number of Extra Awards Banquet Tickets:	$ $
Donation Choose your desired donation level from the drop-down box below. If you wish, you may then edit the amount in the column to the right. Do you wish your donation level listed as "Passerby" (undisclosed amount)? Yes No	$
Total Amount Due	$

Okay. Stop right now, look over everything you entered above, make sure it's correct, and then press this button:

(You must press the button above before continuing! You'll come back to this page afterwards to pay. Did you press the button? PRESS THE BUTTON! You think we're kidding, but about one person a day still doesn't push the button. Don't be that person.)

Your registration is not complete until payment is received.

So how do you pay us?
You may send funds by check or by credit card. You will be sent a confirmation email when your payment is received.

Payment by credit card is handled by PayPal, a reliable and secure money-transfer website. If you have not previously used PayPal, you will be asked to sign up as part of the payment process. Signing up with PayPal is completely free, allows you to send a payment to anyone with an email address, and carries no charges for sending money. You will be sent an itemized receipt by email for your records. If you are not comfortable using PayPal to pay your registration fees, please pay by check instead.

For credit card payments, make sure the form above is filled out so that the total is the way you want it. Then press this button: (You may also return to this page later to pay.)

For check payments, press this button and print your form: Then mail your payment and a copy of the completed form to:

American Nuclear Society
ATTN: Registration
4101 Etcheverry Hall, MC#1730
Berkeley, CA 94720-1730

Checks should be made out to "ASUC / American Nuclear Society".

SECTION 5: REJOICE, YOU ARE DONE

Now go do something interesting.