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July 12 - 18, 2009, Arecibo, Puerto Rico

Single-Dish Summer School

Fifth NAIC/NRAO

Registration Fee Payment Form

This form can be filled-in by Acrobat Reader 5 or newer. If handwriting, please print legibly.

Full Name: Institution: Pay by (check one and follow the instructions below): Credit Card Check or Money Order
1) By credit card: Fill out the following sections, sign, and mail or fax the form to the address below. Type of Credit Card: Card Number: Name on Card: Expiration Date: Signature: ________________________________
(unfortunately we are unable to accept other credit cards)

Payment Method

Visa

MasterCard

2) By check: Please make the check payable to Cornell University in the amount of US $200 and mail it with this form to the address below.

Mailing address

Single Dish Summer School c/o Carmen Torres Arecibo Observatory HC 03 Box 53995 Arecibo, PR 00612 USA (787) 817-6120 (Attn. to Carmen Torres)

Fax number