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{\Large\bf Annual Meeting of the Kentucky Section of the MAA}\\
{\large \bf Northern Kentucky University, Highland Heights KY\\
March 30-31, 2007\\ \mbox{}\\

Meeting Registration Form}\\
{\bf All information must be received by March 16, 2007.}
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\noindent
Name: \quad \hrulefill\\

\noindent
School/Business: \quad \hrulefill\\

\noindent
Address: \quad \hrulefill\\

\noindent
Phone: \quad \hrulefill\\

\noindent
E-mail: \quad \hrulefill\\

\noindent
I am:\mbox{\hspace{.15in}}
$\underline{\mbox{\hspace{.3in}}}$undergrad student\hfill
$\underline{\mbox{\hspace{.3in}}}$grad student\hfill
$\underline{\mbox{\hspace{.3in}}}$student chapter member

\mbox{\hspace{.3in}}
$\underline{\mbox{\hspace{.3in}}}$2-year college faculty\hfill
$\underline{\mbox{\hspace{.3in}}}$4-year college faculty\hfill
$\underline{\mbox{\hspace{.3in}}}$university faculty

\mbox{\hspace{.3in}}
$\underline{\mbox{\hspace{.3in}}}$business/industry/government\hfill
$\underline{\mbox{\hspace{.3in}}}$high school teacher\hfill\hfill\mbox{}

\mbox{\hspace{.3in}}
$\underline{\mbox{\hspace{.3in}}}$male\hfill
$\underline{\mbox{\hspace{.3in}}}$female\hfill(optional)
\hfill\hfill\hfill\hfill\\

\noindent
MAA member: \hfill \mbox{\hspace{.5in}}Yes \mbox{\hspace{.5in}} No\\
I am willing to serve as a KYMAA Section Officer:
\hfill \mbox{\hspace{.5in}}Yes \mbox{\hspace{.5in}} No\\
I am willing to serve on a KYMAA Committee:
\hfill \mbox{\hspace{.5in}}Yes \mbox{\hspace{.5in}} No\\

\noindent
Please check all that apply:\\

\noindent
$\underline{\mbox{\hspace{.5in}}}$\ \
Conference Registration
\hfill
\$ 25 (free for students)\\

\noindent
$\underline{\mbox{\hspace{.5in}}}$\ \
I would like to give a talk at the meeting.
\hfill
No charge\\
\hspace*{.75in}
Please submit an Abstract Form to Tom Richmond by \emph{February 28.}\\

\noindent
$\underline{\mbox{\hspace{.5in}}}$\ \
Friday Banquet
\hfill
\$ 17 (\$ 11 for students)\\

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$\underline{\mbox{\hspace{.5in}}}$\ \
Aftermath (Friday evening)
\hfill
No charge\\

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$\underline{\mbox{\hspace{.5in}}}$\ \
Saturday Business Luncheon
\hfill
\$ 10 (\$ 7 for students)\\

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TOTAL ENCLOSED (checks payable to KY Section of MAA)
\hfill $\underline{\mbox{\hspace{1in}}}$ \mbox{\hspace{.5in}}\\

\noindent
The registration deadline is {\bf March 16th, 2007};
You {\bf MUST} pay in advance to ensure meal reservations.\\

\noindent
{\bf Please submit this registration form to:} \quad
Leanne Faulkner, Kentucky Wesleyan College, 3000 Frederica St., Owensboro, Ky 42302-1039, \tt{LeanneF@kwc.edu}



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