Louisiana Coastal Geology Symposium 2018

Advance Registration Form

 

Print and mail this page or click here for a pdf form (right click and save link as).

Advance registration must be postmarked by June 30, 2018. Checks should be made out to “New Orleans Geological Society” with “LCGS 2018” in the “For” blank.

Regular advance registration is $40. Student advance registration is $5. Speakers and poster presenters receive free registration.

(check one)

_____ I am a regular attendee and enclose a check for $40.

_____ I am a student at _______________ university and enclose a check for $5.

_____I am a speaker and request free registration

_____I am a poster presenter and request free registration

 

Name _____________________________________________

Organization ________________________________________________________

Mailing address ______________________________________________________

____________________________________________________________________

Email address __________________________________________________

Contact phone number _______________________________________________

 

Mail your completed registration form and check to:

John E. Johnston III
Louisiana Geological Survey
3079 Energy, Coast and Environment Building
Baton Rouge, LA 70803

 

Email any questions to John Johnston III at hammer@lsu.edu