Name:

   Institution/Company:

   Department:

   Address:

   City, State/Province:

   ZIP/Postal Code:

   Telephone:  (   )

   FAX:     (   )

   E-mail address:

   Conference Fee:  $10.00

   Dinner Fee:  $16.00 per person.

	Number of tickets for chicken  _____
	Number of tickets for fish     _____

   Total Amount Enclosed:  $ ___________  (must be in US dollars) 

   Check here if you need a receipt for your conference fee __________

   Check here if you need a receipt for your dinner ticket(s) __________

   Please send completed Registration Form with payment (checks payable
   to "Joseph W. Manke, Chmn, 1997 PNWNAS") to:

	Joe Manke, 1997 PNWNAS Chmn.
	c/o The Boeing Company
	P. O. Box 3707, Mail Stop 7L-21
	Seattle, WA 98124

Back to PNWNAS homepage