MIAMI UNIVERSITY THIRTY - FIRST ANNUAL PI MU EPSILON STUDENT CONFERENCE
STUDENT REGISTRATION FORM
Faculty Name ___________________________
School Affiliation __________________________
Address ______________________________
______________________________
______________________________
Email Address _____________________________
Telephone Number _________________________
NO REGISTRATION FEE
FOR STUDENTS
Student Name
______________________
______________________
______________________
______________________
______________________
Sex
M or F?
________
________
________
________
________
Need
Lodging
With M.U.
Student?
_________
_________
_________
_________
_________
Speaker?
YES
or
NO
_________
_________
_________
_________
Will
Attend
Free Fri.
Pizza
Party?
________
________
________
________
Estimated Time of Arrival: _______________________________________________
Will
Attend
Saturday
Picnic
Lunch?
_________
_________
_________
_________
TOTAL:
$5.00
Enclosed
For Picnic
(Speakers
Free)
________
________
________
________
$ ________
If any students are coming by air, see the Cincinnati Airport-to-Oxford transportation information in the "Mathematics &
Symmetry" Conference flyer.
Students lodging with Miami students must bring sleeping bags.
Mail this and, when appropriate, a check payable to Miami University, 31st Annual Pi Mu Epsilon Student
Conference, Dept. of Mathematics and Statistics, Miami University, Oxford, Ohio 45056 by September 24, 2004.
You may email the informational part to coxmd@muohio.edu.
Name of Speaker: ___________________________________Email Address_______________________
Title of Talk:
_____________________________________________________________________
_____________________________________________________________________
Length of Talk:
(circle or bold one) 15 minutes
30 minutes
(circle or bold one) Friday Night, between 7:00 - 9:15 (choose Friday if possible)
or
Saturday Afternoon, between 2:30 - 3:45
Brief Abstract:
Presentation Time:
(50 words approx.)
Special A-V Needs:
Please enclose similar information for each speaker. Return this form by September 24 to Pi Mu Epsilon Student
Conference at the same address as above, fax this information to Math/Stat Dept at (513) 529-1493, or e-mail it to
coxmd@muohio.edu by September 24. Since the program agenda will not be finalized until the last week, we may be
unable to confirm your presentation time by mail. Give us a call or e-mail if you need this information. Thanks.