Registration
Form
The 2008 J. K. Russell Research
Conference,
"Twenty Years After the New View from
on Science and Religion"
Dr. George V. Coyne, S.J.
Saturday, March
15, 2008, 10:30 am – 5:00 pm
(Registration and coffee begin at 10:15 am)
Location GTU Board Room, Hewlett
Library, 2400 Ridge Rd.,
Lunch will be included in the registration fee if registration is received by March 10.
(There is a discounted
registration for 2008 CTNS
members). Please register early
to secure your space.
___General Registration: $45;
___General Registration, F.T. Student or Senior (62 or over): $35
___CTNS Current Member Registration: $35;
___CTNS Current Member
Registration, F.T. Student or Senior: $20
__ I’d like to join CTNS for 2008, to receive the
quarterly journal, Theology and
Science and a discount on this conference.
Please Check: __ Regular Member
$67;
__Senior
(62 & over) or Student Membership
$40
___ Total $ enclosed (or charged to
my Visa or MasterCard)
Make checks payable to CTNS and earmarked JK Russell Conference.
Mail to CTNS--J.K. Russell
Conference,
Note: seating is limited.
Please register early.
Phone: (510) 848-8152 -
www.ctns.org
If paying by credit
card, you may fax your RSVP to CTNS at
510-848-2535 or call 510-848-8152 between the hours of 9 am and 5 pm
PST.
Name (s)
Address
City/State
Zip
Email address (for confirmation)
Phone:
__
Bill my credit card:
____VISA ____MasterCard
__ The address above is my billing address.
___
___ ___ ___- ___ ___ ___ ___- ___ ___ ___ ___- ___ ___ ___
___
Credit
Card number
Expiration
Date ____________
Security number on back of card ___ ___ ___
Signature:
______________________________________________________