Thank you for your interest in attending the GEO Forum. Below is the registration form you must fill out to attend this event. There is no fee for attending this event, however space is limited.

You will receive a badge and conference bag when you check in at the registration desk. Complimentary meals and snacks, as well as admission to the reception are included with your registration.

If you have any questions, contact Gloria Kelly at (303) 497-2102 or gloriak@ucar.edu

Name:

University: Anticipated year of graduation: Select Year: 2004 2005 2006 2007 2008 2009 Declared Major or Intended Field of Study:

Mailing Address:

Telephone Number:

FAX:

E-mail: Optional: Race/Ethnicity: Select: American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Hispanic or Latino Gender: Male Female Birthdate:

Special Needs: Please let us know if you have any special needs (e.g. wheelchair access, hearing impaired, etc.)