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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
an Institute previously?

            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)?
1        2        3         4        5         6        7         8        9         10
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

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. 

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This page was updated on 01/30/07