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PARI Star Party Registration Form

Please complete this form to register for the PARI Star Party, December 14-16, 2012. Your registration will be confirmed by email or phone upon receipt of your check or online payment of $50 for registration made to "PARI" by the PARI Acounting Office. Please include your housing fees if needed in the same check. All meals are included in the registration fee.

Please complete one registration form for each person attending. You must close your browser before attempting to register a second person.

Question details

Name: (Required)

Please enter your first and last name.

Astronomy Club or Organization Affiliation:

Please list your organization's name here.

Email Address:

Enter your email address here.

Is it okay to add this email address to PARI's notification service?

Please indicate your permission to add this email address to PARI's notification service about other educational and public events.

Yes
No

Address:

Enter your street address here.

Address 1:

Continue address here if needed:

City: (Required)

Enter your city here.

State: (Required)

Enter your state here.

Zip Code: (Required)

Enter your Zip Code here.

Phone Number: (Required)

Enter a phone number at which we can confirm your registration.

Dietary Needs (Required)

Indicate any dietary considerations needed.

None
Vegetarian
Other (Please describe needs in the section below.)

Decribe needs if "Other" is selected.

Special Considerations:

Please list any special considerations for PARI staff in arranging your visit - e.g. Wheelchair access, parking near sleeping area, large vehicle, etc.

Roommate Preference:

Please list the person you prefer as your roommate.

Gender

Please indicate gender for housing arrangements.

Female
Male

Housing and Registration Fees (Required)

Please indicate your housing preferences here.

Regstration only; no housing needed ($50)
Registration and on campus (gender segregated) housing ($150 total)
Registration and camping ($100)

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