American Phytopathological Society

Potomac Division

Name (for name tag, PLEASE PRINT):

Organization:

Address:

Telephone #:

Fax:

E-mail:

Registration (includes social hours, coffee breaks, continental breakfast on Thu and Fri, and lunch and Banquet dinner on Thu) Regular registration - $95.00 ($110.00 after March 7) Student or Emeritus registration - $50.00 ($ 60.00 after March 7)	__________
Additional banquet tickets (spouse or guest) @ $30.00 number___ Amount: Please indicate any special dietary needs or restrictions:	__________
Longwood Gardens tour (Wed afternoon, Mar 22) ($10.00) (deadline to sign up: March 16, to bobmul@udel.edu)	__________
Potomac Division Memorial Fund Contribution:	__________
Contribution to help defray cost of next Annual Meeting Potomac Division Social	__________
Abstract Fee - $30.00 per abstract (for publication in Phytopathology)	__________
Potomac Division dues ($10.00 regular, $5.00 student) are normally paid with the APS membership. If you would like to become a Potomac Division member, you may include your dues with this form (at least one author of a paper or poster must be a member.)	__________
TOTAL	__________

Make checks payable to Potomac Division, APS. Mail registration form and payment to :

Anton Baudoin Department of Plant Pathology, Physiology and Weed Science Virginia Tech Blacksburg, VA, 24061-0331

DEADLINE FOR PRE-REGISTRATION at the discounted rate: postmarked by March 7

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