Tucson Audubon Society
Institute of Desert Ecology Registration Form
Print and mail this form to Tucson Audubon Society.
Cost for the program is $425 ($395 for Tucson Audubon members). A non-refundable deposit of $80 per person must accompany the registration
form. The balance ($315 for members; $345 for non-members and members of
National Audubon Society only)
is due March 6, 2009. Make checks payable to the Tucson Audubon Society. Send form to: Tucson Audubon Society,
300 E University Blvd, #120, Tucson, AZ, 85705.
Contact Matt Brooks at (520)
622-2230 for
more information.
| Name: | Ms. Mrs. Mr. |
| Address: | |
| City, St, Zip: | |
| Home phone: | |
| Work phone: | |
| Email: | |
| Tucson Audubon member? | Y N |
Study Group Assignment: The following information will be used to assure a mix of participants in study groups:
| Occupation: If retired, please specify previous occ. |
||
| Interests or hobbies: | ||
| Age: | 18-35 36-60 Over 60 | |
|
Have you
attended |
Y N | |
How much previous exposure to natural history have you had,
on a scale from 1 (no exposure) to 10 (college degree or equivalent)? |
||
| I would like to be in the same study group as: _______________________ | ||
Accommodations
| Check one: | |
| I will bring a tent and sleeping bag. | |
| I will bring a camper. Type: _____________________ | |
| If possible, I would like to share
someone's tent or camper (I am a: ___ smoker ___ non-smoker) |
|
| I am willing to share my tent or camper (___ non-smoker only) |
Other Information
| A one-of-a-kind 2009 IDE t-shirt is included in the registration fee. NO shirt please __________ Mark size preference: S M L XL XXL Add’l shirts:___________ (Add’l shirts $16.50 - $25.00, depending on style) Style preference: Regular ________ Long-sleeve ________ Women’s Scoop ________ (only in short sleeve) |
Are you interested in donating an additional $20 towards Institute of Desert Ecology scholarships? Yes ______ No ______
| Check here: | We compile a roster for Institute participants only. May we: |
| Please do not include any of my information | |
| Please do not include my telephone number | |
| Please do not include my occupation or interests | |
| Where did you learn about the Institute of Desert Ecology? | |
| Do you know others who would like to attend? Please give an email or address.
|
|
| Other questions or
comments?
|
|
| In case of emergency, notify: ( someone who will not be at the Institute) | |
| Name: | |
| Address: | |
| City, St, Zip: | |
| Home Phone: | |
| Work Phone: | |
If my registration is accepted, I understand $80 of the fee is not refundable. I am at least 18 years of age, in good health, require no special diet, and plan to participate in the full Institute program.
Signature ______________________________________ Date _____________
Enclose $80 deposit (balance due March 6, 2009) or full payment of $425 ($395 for Audubon members). Make check payable to Tucson Audubon Society.
Bird questions? Check Birding | General questions? Contact: Tucson Audubon Society | Webmaster: Email
This page was updated on 05/15/08