Registration

REGISTRATION FORM

SCIENCE ALIVE Conference - May 19-22, 2004

Registration Deadline April 5, 2004

SPACE IS LIMITED TO FIRST 250 Paid Registrations – Don’t Delay!

One registration form per person, please. (Print this form as necessary)

Name_____________________________________

School / Affiliation_______________________________ ___________ _

Address________________________________________________

City______________________State_____ZIP_______________

E-Mail _______________________

Work Phone (_ __)_______-________ Home Phone (_ ____) ______-_________ FAX (__ ___)______-_________

Early Bird Registration

Registration paid in full by February 20, 2004

q Teacher / Adult $375 Includes all meals, tours, curriculum, materials

q Student H.S. / College $250 Includes all meals, tours, and materials

q Spouse/Child $200 Includes all meals and tours

q "Build Your Own Systems" materials / shipping fee $75 (limited to first 48 participants)

Regular Registration

Registration paid in full between February 21 and April 5, 2004

q Teacher / Adult $420 Includes all meals, tours, curriculum, materials

q Student H.S. / College $300 Includes all meals, tours, and materials

q Spouse/Child $225 Includes all meals and tours

q "Build Your Own Systems" materials / shipping fee $75 (limited to first 48 participants)

Method of Payment

Registration $_______.00

"Build your Own System" Materials Fee $___ ___.00

Total amount due $ _ _.00

Check #_______________ Purchase Order #____________________

___Please Invoice

Visa MasterCard Credit card # __ __ __ __-__ __ __ __-__ __ __ __-__ __ __ __ -__ __ __

(include the last 3 digits on the back of the card)

Signature_______________________________________________________ Expiration Date_____________________

Make checks or purchase orders payable to: Flowing Wells Extension Programs

Mail Registration & Payment to: NOTE: A Cancellation fee of $100 will be

Science Alive Conference assessed after April 5th

3725 N Flowing Wells Rd

Tucson, AZ 85705

We are striving to maintain the individual attention and small class sizes that have made this conference a success. In order to do so, we are limiting total participation to 250 people. We anticipate that the conference will fill quickly. A $25/person non-refundable deposit will hold your space. The balance of payment is due by February 20th in order to receive an Early Bird Discount or by April 5th for regular registration.

Confirmation of your registration will be sent within 10 working days. Please call Aaron Ball at

520-690-2332 with any questions.

Name

Wednesday, May 19, 2004 Pre-conference Options

___I will not be participating in a pre-conference tour

I will be participating in the following pre-conference tour (please choose one):

___ Eurofresh ___ Arizona Sonora Desert Museum ___ San Xavier Mission

___I will be attending the 7pm Opening Banquet at the Radisson Hotel

___I will not be attending the Opening Banquet

Conference Training Sessions (5 hour sessions)

Offered both Thursday, May 20th and Friday, May 21st

Note: Most training sessions have limited enrollments. Register early to ensure your choices!

Please number your top two choices and indicate your alternate as #3 (see attached descriptions)

	From Seeding to Harvest		NFT Lettuce and Herb Production
	Hydroponics Tomato Production for the Classroom		Biotechnology-Tissue Culture
	Aquaponics in the Classroom		Advanced Biotechnology
	Water Quality and Nutrient Recipes		Desgning, Building and Troubleshooting Irrigation Systems

Conference Funshops (75 minute presentations)

Offered both Thursday, May 20th and Friday, May 21st

Please choose four

	CHOOSING THE RIGHT HYDROPONICS/AQUACULTURE SYSTEM		TEACHERS SHARE UNIQUE THINGS THEY ARE DOING
	CROPS AND VARIETIES FOR MY CLIMATE		Q&A CLASSROOM AND GREENHOUSE MANAGEMENT
	HYDROPONIC STRAWBERRY PRODUCTION		SELECTING THE RIGHT GREENHOUSE
	LETTUCE AND HERB PRODUCTION		BIOLOGICAL INSECT CONTROL
	MARKETING YOUR PRODUCTS		BASIC PLANT BIOLOGY
	FINANCING AND GRANTS		SIX SYSTEMS YOU CAN BUILD
	AGRISCIENCE AND SCIENCE FAIR PROJECTS		DESKTOP AQUAPONICS
	BUILD YOUR OWN SYSTEM (class fee)

Closing Banquet, Friday May, 21 2004

___I will be attending the Closing Banquet, 7 pm at the Radisson Hotel

___I will not be attending the Closing Banquet

Saturday May 22, 2004 Post-conference Options

___I will not be participating in a post-conference tour.

I will be participating in the following post-conference tour (please choose one)

___ Eurofresh ___ Arizona Sonora Desert Museum ___ Old Tucson

___I give permission for my name, school address, phone, e-mail, etc., to be published in a conference directory to be given to each attendee.

___ I give permission for my photograph to be used in future Science Alive publications including the web site, brochure, and promotional video. (students must have the signature of a parent/guardian).

(signature) (date)