Registration Deadline for Individuals: March 25, 2009
Registration Deadline for Groups of less than 10: March 25, 2009
Registration Deadline for Groups of 10 or more: March 21, 2009
Student Registration Fee: $5.00 (non-refundable) in advance, $10.00 on-site (if space available). Fee may be waived by having your teacher sign below.

Return registration form & fee to:    CEYH c/o NMNWSE

Make checks payable to:     Expanding Your Horizons (EYH). Your check is your receipt.

Please Print Carefully. Thanks!

Last Name___________________________________    First Name_______________________________

Address______________________________________________________________________

City_______________________________________________________    Zip______________

Phone________________________    School____________________________________________

Grade (circle one):

6

7

8

9

10

11

12

From among the workshop catagories listed, choose your top three categories of interest.
Your workshops will be assigned based your interest.

Rank 1-3	Category
	Medical/Life Sciences
	Engineering/Technology
	Mathematics/Computer Science
	General Science
	Other: ______________________________________________________________

If the $5 fee presents a financial hardship, please have your teacher sign here:

______________________________________________________________________
Your teacher's signature waives the registration fee.

How did you hear about the EYH Conference?_____________________________________

Please indicate any special assistance or help needed, such as wheelchair access: