RUMBUS Registration Form

Please complete the following form. If you prefer, you may submit a hardcopy of this form to the following address:

Emma Previato, RUMBUS03 Organizer
Department of Mathematics & Statistics
Boston University
Boston, MA 02215-2411
e-mail ep@bu.edu

First name

Last name

Institution -- or town (if you lack affiliation)

E-Mail		Position

		*Other Description (e.g. math aficionado, MAA member, etc)*

Do you plan to attend breakfast?